Provider Demographics
NPI:1982252185
Name:GOWER, AMANDA JANE (PA-C)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:JANE
Last Name:GOWER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 478
Mailing Address - Street 2:
Mailing Address - City:BARTONSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18321-0478
Mailing Address - Country:US
Mailing Address - Phone:570-276-0643
Mailing Address - Fax:570-872-9255
Practice Address - Street 1:101 POCONO CMNS STE 101
Practice Address - Street 2:
Practice Address - City:STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18360-7599
Practice Address - Country:US
Practice Address - Phone:570-872-9955
Practice Address - Fax:570-872-9255
Is Sole Proprietor?:No
Enumeration Date:2019-08-30
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA060907363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical