Provider Demographics
NPI:1578815619
Name:KO, ALLISON MOORE (PA-C)
Entity Type:Individual
Prefix:MISS
First Name:ALLISON
Middle Name:MOORE
Last Name:KO
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:3809 COMPUTER DR STE 100
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-6518
Mailing Address - Country:US
Mailing Address - Phone:919-781-9078
Mailing Address - Fax:919-350-8812
Practice Address - Street 1:3000 NEW BERN AVE
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-1231
Practice Address - Country:US
Practice Address - Phone:919-350-8779
Practice Address - Fax:919-350-8812
Is Sole Proprietor?:No
Enumeration Date:2012-10-14
Last Update Date:2022-11-09
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Provider Licenses
StateLicense IDTaxonomies
NC001003863363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant