Provider Demographics
NPI:1841435385
Name:BARNES, AMANDA M (PA)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:M
Last Name:BARNES
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:196 ARROWHEAD DR
Mailing Address - Street 2:SUITE 8
Mailing Address - City:EVANSTON
Mailing Address - State:WY
Mailing Address - Zip Code:82930-8752
Mailing Address - Country:US
Mailing Address - Phone:435-613-9500
Mailing Address - Fax:435-613-9414
Practice Address - Street 1:196 ARROWHEAD DR
Practice Address - Street 2:SUITE 8
Practice Address - City:EVANSTON
Practice Address - State:WY
Practice Address - Zip Code:82930-8752
Practice Address - Country:US
Practice Address - Phone:307-789-1390
Practice Address - Fax:307-789-1391
Is Sole Proprietor?:No
Enumeration Date:2008-12-12
Last Update Date:2009-10-19
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Provider Licenses
StateLicense IDTaxonomies
WY465363A00000X
WYPENDING363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily