Provider Demographics
NPI:1588968812
Name:HERRINGTON, AMANDA DARDEN (PA-C)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:DARDEN
Last Name:HERRINGTON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:607 BEAMAN ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NC
Mailing Address - Zip Code:28328
Mailing Address - Country:US
Mailing Address - Phone:910-592-8511
Mailing Address - Fax:910-596-6106
Practice Address - Street 1:301 MAIN ST
Practice Address - Street 2:
Practice Address - City:NEWTON GROVE
Practice Address - State:NC
Practice Address - Zip Code:28366
Practice Address - Country:US
Practice Address - Phone:910-594-0003
Practice Address - Fax:910-594-0028
Is Sole Proprietor?:No
Enumeration Date:2010-12-30
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-02671363AM0700X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical