Provider Demographics
NPI:1225309883
Name:ROBERTS, ALLISON JOANNE (APN)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:JOANNE
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3633 CENTRAL AVE STE N
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-6475
Mailing Address - Country:US
Mailing Address - Phone:501-623-6100
Mailing Address - Fax:501-623-3403
Practice Address - Street 1:3633 CENTRAL AVE STE N
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS NATIONAL PARK
Practice Address - State:AR
Practice Address - Zip Code:71913-6475
Practice Address - Country:US
Practice Address - Phone:501-623-6100
Practice Address - Fax:501-623-6187
Is Sole Proprietor?:No
Enumeration Date:2012-01-13
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA03565ANP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR199115758Medicaid
ARA003565OtherSTATE LICENSE