Provider Demographics
NPI:1407385479
Name:GUILLARD, ALLISON M (CRNP)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:M
Last Name:GUILLARD
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:I
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:905 UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-6626
Mailing Address - Country:US
Mailing Address - Phone:814-238-8418
Mailing Address - Fax:814-234-2888
Practice Address - Street 1:905 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-6626
Practice Address - Country:US
Practice Address - Phone:814-238-8418
Practice Address - Fax:814-234-2888
Is Sole Proprietor?:No
Enumeration Date:2017-06-05
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP017832363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology