Provider Demographics
NPI:1912284282
Name:BARKMAN, ALYSSA JEAN (PA-C)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:JEAN
Last Name:BARKMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:JEAN
Other - Last Name:POSTERICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2550 UNIVERSITY AVE W
Mailing Address - Street 2:STE 110
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55114-2001
Mailing Address - Country:US
Mailing Address - Phone:651-602-5311
Mailing Address - Fax:651-222-3786
Practice Address - Street 1:6025 LAKE ROAD
Practice Address - Street 2:STE 110
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-1709
Practice Address - Country:US
Practice Address - Phone:651-735-7414
Practice Address - Fax:651-735-1827
Is Sole Proprietor?:No
Enumeration Date:2011-11-14
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN11044OtherLICENSE PHYSICIAN ASSISTANT