Provider Demographics
NPI:1033453428
Name:MOORE, ALLISON VERNET (PA-C, RD, CDE)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:VERNET
Last Name:MOORE
Suffix:
Gender:F
Credentials:PA-C, RD, CDE
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:MARIE
Other - Last Name:VERNET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6 BUTTRICK RD STE 102
Mailing Address - Street 2:
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-3417
Mailing Address - Country:US
Mailing Address - Phone:603-537-1300
Mailing Address - Fax:
Practice Address - Street 1:50 MICHELS WAY STE 102
Practice Address - Street 2:
Practice Address - City:LONDONDERRY
Practice Address - State:NH
Practice Address - Zip Code:03053-3420
Practice Address - Country:US
Practice Address - Phone:603-537-1300
Practice Address - Fax:603-845-1830
Is Sole Proprietor?:No
Enumeration Date:2012-11-26
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1570363AM0700X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical