Provider Demographics
NPI:1538208335
Name:MITCHELL-BARNES, DONNA JEAN (PA-C)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:JEAN
Last Name:MITCHELL-BARNES
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 1:285 OLMSTED BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-8731
Mailing Address - Country:US
Mailing Address - Phone:910-295-7246
Mailing Address - Fax:910-222-3168
Practice Address - Street 1:285 OLMSTED BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-8731
Practice Address - Country:US
Practice Address - Phone:910-295-7246
Practice Address - Fax:910-222-3168
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-00260363A00000X, 363AM0700X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2765336Medicare PIN
NCNC5822F921Medicare PIN
NCQ62421Medicare UPIN