Basic Information
| Provider Information | |||||||||
| NPI: | 1982252185 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GOWER | ||||||||
| FirstName: | AMANDA | ||||||||
| MiddleName: | JANE | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 478 | ||||||||
| Address2: | |||||||||
| City: | BARTONSVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 183210478 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5702760643 | ||||||||
| FaxNumber: | 5708729255 | ||||||||
| Practice Location | |||||||||
| Address1: | 101 POCONO CMNS STE 101 | ||||||||
| Address2: | |||||||||
| City: | STROUDSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 183607599 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5708729955 | ||||||||
| FaxNumber: | 5708729255 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2019 | ||||||||
| LastUpdateDate: | 03/25/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | MA060907 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.