Provider Demographics
NPI:1154157980
Name:BARNHART, ANNALIESE (PA)
Entity type:Individual
Prefix:
First Name:ANNALIESE
Middle Name:
Last Name:BARNHART
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:943 DEERWOOD LN
Mailing Address - Street 2:
Mailing Address - City:LAINGSBURG
Mailing Address - State:MI
Mailing Address - Zip Code:48848-8603
Mailing Address - Country:US
Mailing Address - Phone:231-519-0616
Mailing Address - Fax:
Practice Address - Street 1:939 WILSON RD
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48824-6410
Practice Address - Country:US
Practice Address - Phone:231-519-0616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant