Healthcare Provider Details

I. General information

NPI: 1093908352
Provider Name (Legal Business Name): AMANDA MARLENE BARRON-HALL CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMANDA MARLENE BARRON CRNP

II. Dates (important events)

Enumeration Date: 08/21/2007
Last Update Date: 08/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

841 HOSPITAL ROAD SUITE 3500
INDIANA PA
15701
US

IV. Provider business mailing address

841 HOSPITAL ROAD SUITE 3500
INDIANA PA
15701
US

V. Phone/Fax

Practice location:
  • Phone: 724-349-8636
  • Fax: 724-465-4087
Mailing address:
  • Phone: 724-349-8636
  • Fax: 724-465-4087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP009503
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: