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General NPI Number Information
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NPI Number | 1861501363
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Entity Type | Individual
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Provider Name | AMANDA E EARL PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 09/26/2007
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Provider Practice Location Address
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Address Line | 9149 ESTATE THOMAS PARAGON MEDICAL BUILDING SUITE 104
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City | ST. THOMAS
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State | VI
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Zip | 00802
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Country | US
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Telephone | 340-714-2845
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Fax |
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Provider Business Mailing Address
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Address Line | 9149 ESTATE THOMAS SUITE 1074
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City | ST THOMAS
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State | VI
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Zip | 00802-2615
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Country | US
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Telephone | 340-714-2845
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Fax | 603-924-3993
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 0337P
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License Number State | NH
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