Provider Demographics
NPI:1487108841
Name:BARNES, ROBIN (PA-C)
Entity type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:
Last Name:BARNES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:ROBIN
Other - Middle Name:
Other - Last Name:PHELPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:5350 PERSHING AVE
Mailing Address - Street 2:UNIT 1A
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63112-1779
Mailing Address - Country:US
Mailing Address - Phone:270-703-6273
Mailing Address - Fax:
Practice Address - Street 1:10010 KENNERLY RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128
Practice Address - Country:US
Practice Address - Phone:314-525-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-15
Last Update Date:2018-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA008808363A00000X
MO2016016638363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant