Provider Demographics
NPI:1154485977
Name:ALSTON, VERONICA L (PA-C)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:L
Last Name:ALSTON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:JOEL HEALTH CLINIC BLDG 4851
Mailing Address - Street 2:
Mailing Address - City:FORT BRAGG
Mailing Address - State:NC
Mailing Address - Zip Code:28310-0001
Mailing Address - Country:US
Mailing Address - Phone:910-907-9159
Mailing Address - Fax:910-907-1038
Practice Address - Street 1:JOEL HEALTH CLINIC BLDG 4851
Practice Address - Street 2:
Practice Address - City:FORT BRAGG
Practice Address - State:NC
Practice Address - Zip Code:28310-0001
Practice Address - Country:US
Practice Address - Phone:910-907-5635
Practice Address - Fax:910-907-1038
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
1073873363AM0700X
NC0010-02314208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine