Provider Demographics
NPI:1417047259
Name:KEREKES, ALISON P (PAC)
Entity Type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:P
Last Name:KEREKES
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:MISS
Other - First Name:ALISON
Other - Middle Name:R
Other - Last Name:PARSONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PAC
Mailing Address - Street 1:5118 HUXEY GLENN CT
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-9293
Mailing Address - Country:US
Mailing Address - Phone:330-509-5517
Mailing Address - Fax:
Practice Address - Street 1:DUKE UNIVERSITY MEDICAL CTR
Practice Address - Street 2:BOX 3902
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-0001
Practice Address - Country:US
Practice Address - Phone:919-684-1817
Practice Address - Fax:919-681-8147
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA18242363AM0700X
NC0010-01889363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPA18242OtherPA STATE LICENSE
NC0010-01889OtherNC PHYSICIAN ASSISTANT LICENSE
CAPA18242OtherPA STATE LICENSE
NC0010-01889OtherNC PHYSICIAN ASSISTANT LICENSE
NCMK1998143OtherNC DEA