Provider Demographics
NPI:1598183220
Name:O'DEA, ALISON MARGARET (ACNP-BC, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:MARGARET
Last Name:O'DEA
Suffix:
Gender:F
Credentials:ACNP-BC, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 N FRONT ST
Mailing Address - Street 2:
Mailing Address - City:WORMLEYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17043-1034
Mailing Address - Country:US
Mailing Address - Phone:717-731-0101
Mailing Address - Fax:
Practice Address - Street 1:1000 N FRONT ST
Practice Address - Street 2:
Practice Address - City:WORMLEYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17043-1034
Practice Address - Country:US
Practice Address - Phone:717-731-0101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-31
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0127700363LA2100X
PASP015084363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care