Provider Demographics
NPI:1235637653
Name:BARRETT, ALLISON RAGO (CRNP)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:RAGO
Last Name:BARRETT
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:
Other - Last Name:RAGO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3400 CIVIC CENTER BLVD
Mailing Address - Street 2:3 WEST
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-5127
Mailing Address - Country:US
Mailing Address - Phone:215-615-5858
Mailing Address - Fax:215-615-3349
Practice Address - Street 1:3400 CIVIC CENTER BLVD
Practice Address - Street 2:3 WEST
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-5127
Practice Address - Country:US
Practice Address - Phone:215-615-5858
Practice Address - Fax:215-615-3349
Is Sole Proprietor?:No
Enumeration Date:2018-01-31
Last Update Date:2019-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP018479363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily