Provider Demographics
NPI:1508143215
Name:WOLFE, ALLISON MARY (PA-C)
Entity Type:Individual
Prefix:MS
First Name:ALLISON
Middle Name:MARY
Last Name:WOLFE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MRS
Other - First Name:ALLISON
Other - Middle Name:MARY
Other - Last Name:ROHRER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:81 CLARION RD
Mailing Address - Street 2:
Mailing Address - City:JOHNSONBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15845-1656
Mailing Address - Country:US
Mailing Address - Phone:814-389-4411
Mailing Address - Fax:814-389-4142
Practice Address - Street 1:81 CLARION RD
Practice Address - Street 2:
Practice Address - City:JOHNSONBURG
Practice Address - State:PA
Practice Address - Zip Code:15845-1656
Practice Address - Country:US
Practice Address - Phone:814-389-4411
Practice Address - Fax:814-389-4142
Is Sole Proprietor?:No
Enumeration Date:2011-11-09
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA055175363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMA055175OtherCOMMONWEALTH OF PENNSYLVANIA
PAOA003213OtherPA OSTEOPATHIC BOARD OF MEDICINE