Provider Demographics
NPI:1326473471
Name:ROSS, ALLISON DAVIS (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:DAVIS
Last Name:ROSS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4041 ED DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-8004
Mailing Address - Country:US
Mailing Address - Phone:919-324-3385
Mailing Address - Fax:919-324-3404
Practice Address - Street 1:4041 ED DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-8004
Practice Address - Country:US
Practice Address - Phone:919-324-3385
Practice Address - Fax:919-324-3404
Is Sole Proprietor?:No
Enumeration Date:2013-09-09
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-04459363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant