Provider Demographics
NPI:1558483834
Name:PRABHAKAR, ALLISON LEIGH (RN, MSN, APN-C)
Entity Type:Individual
Prefix:MS
First Name:ALLISON
Middle Name:LEIGH
Last Name:PRABHAKAR
Suffix:
Gender:F
Credentials:RN, MSN, APN-C
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Mailing Address - Street 1:770 NEWTOWN YARDLEY RD
Mailing Address - Street 2:SUITE 220A
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-4501
Mailing Address - Country:US
Mailing Address - Phone:215-968-4804
Mailing Address - Fax:415-968-4759
Practice Address - Street 1:770 NEWTOWN YARDLEY RD
Practice Address - Street 2:SUITE 220A
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-4501
Practice Address - Country:US
Practice Address - Phone:215-968-4804
Practice Address - Fax:415-968-4759
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2012-09-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00122500363L00000X
CANP 19450363LA2200X
PASP009987363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner