Provider Demographics
NPI:1962703645
Name:EARNEST, AMY L (PA-C)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:L
Last Name:EARNEST
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:479 THOMAS JONES WAY STE 300
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-2552
Mailing Address - Country:US
Mailing Address - Phone:610-280-9999
Mailing Address - Fax:215-615-1320
Practice Address - Street 1:479 THOMAS JONES WAY STE 300
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2552
Practice Address - Country:US
Practice Address - Phone:610-280-9999
Practice Address - Fax:215-615-1320
Is Sole Proprietor?:No
Enumeration Date:2010-11-11
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA058188363AM0700X, 363AM0700X
DEC5-0000767363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical