Provider Demographics
NPI:1376546663
Name:LANPHIER, ALLISON SUE (PA)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:SUE
Last Name:LANPHIER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:SUE
Other - Last Name:HARTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:1002 S LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:50138-3121
Mailing Address - Country:US
Mailing Address - Phone:641-828-7211
Mailing Address - Fax:
Practice Address - Street 1:1202 W HOWARD ST
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:IA
Practice Address - Zip Code:50138-3103
Practice Address - Country:US
Practice Address - Phone:641-828-7211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001012363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA2203703Medicaid
IA36238OtherBCBS PROVIDER #
IA2203703Medicaid
IAI11284Medicare PIN