Provider Demographics
NPI:1275640484
Name:SOERENS, ALLISON E (APNP)
Entity Type:Individual
Prefix:MS
First Name:ALLISON
Middle Name:E
Last Name:SOERENS
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CEDAR GROVE
Mailing Address - State:WI
Mailing Address - Zip Code:53013-1611
Mailing Address - Country:US
Mailing Address - Phone:920-668-8502
Mailing Address - Fax:920-668-8093
Practice Address - Street 1:313 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CEDAR GROVE
Practice Address - State:WI
Practice Address - Zip Code:53013-1611
Practice Address - Country:US
Practice Address - Phone:920-668-8502
Practice Address - Fax:920-668-8093
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1483363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43903700Medicaid
WI43903700Medicaid