Provider Demographics
NPI:1851128326
Name:JARKA, LYDIA ROSE (PA-C)
Entity type:Individual
Prefix:
First Name:LYDIA
Middle Name:ROSE
Last Name:JARKA
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 250
Mailing Address - Street 2:
Mailing Address - City:TIERRA AMARILLA
Mailing Address - State:NM
Mailing Address - Zip Code:87575-0250
Mailing Address - Country:US
Mailing Address - Phone:575-588-7252
Mailing Address - Fax:575-756-2821
Practice Address - Street 1:US HIGHWAY 84 COUNTY ROAD 0324 #14
Practice Address - Street 2:
Practice Address - City:TIERRA AMARILLA
Practice Address - State:NM
Practice Address - Zip Code:87575
Practice Address - Country:US
Practice Address - Phone:575-588-7252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-18
Last Update Date:2025-03-19
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant