Provider Demographics
NPI:1568421899
Name:WALSH, ALLISON ELIZABETH (PAC)
Entity Type:Individual
Prefix:MS
First Name:ALLISON
Middle Name:ELIZABETH
Last Name:WALSH
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-467-6789
Mailing Address - Fax:
Practice Address - Street 1:920 E 2ND AVE STE 201A&B
Practice Address - Street 2:
Practice Address - City:CORALVILLE
Practice Address - State:IA
Practice Address - Zip Code:52241-2219
Practice Address - Country:US
Practice Address - Phone:319-467-2000
Practice Address - Fax:319-467-2815
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001502363AM0700X, 363AS0400X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P95217Medicare UPIN
P95217Medicare UPIN