Provider Demographics
NPI:1356793335
Name:BARNES, ELIZABETH M (PA-C)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:M
Last Name:BARNES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:FELTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5 INDUSTRIAL DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:MASHPEE
Mailing Address - State:MA
Mailing Address - Zip Code:02649-3464
Mailing Address - Country:US
Mailing Address - Phone:508-539-2444
Mailing Address - Fax:508-539-2445
Practice Address - Street 1:5 INDUSTRIAL DR
Practice Address - Street 2:SUITE 202
Practice Address - City:MASHPEE
Practice Address - State:MA
Practice Address - Zip Code:02649-3464
Practice Address - Country:US
Practice Address - Phone:508-539-2444
Practice Address - Fax:508-539-2445
Is Sole Proprietor?:No
Enumeration Date:2016-07-01
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAPA5894OtherMA MEDICAL LICENSE
MAS400338237Medicare PIN