Individual
AMANDA R. HERRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
410 W 10TH AVE, COLUMBUS, OH 43210-1240
(614) 293-8305
(614) 293-3124
Mailing address
700 ACKERMAN RD STE 2120, COLUMBUS, OH 43202-1559
(614) 293-8305
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.008635RX
OH
363AM0700X
Medical Physician Assistant
022723
NY
363AM0700X
Medical Physician Assistant
PA9113200
FL
Other
Enumeration date
10/05/2018
Last updated
11/01/2024
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