Provider Demographics
NPI:1649405192
Name:DONAVOS, ALLYSON S (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:ALLYSON
Middle Name:S
Last Name:DONAVOS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MS
Other - First Name:ALLYSON
Other - Middle Name:S
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-851-1700
Mailing Address - Fax:717-715-1302
Practice Address - Street 1:3065 WINDSOR RD
Practice Address - Street 2:
Practice Address - City:RED LION
Practice Address - State:PA
Practice Address - Zip Code:17356-8533
Practice Address - Country:US
Practice Address - Phone:717-851-1700
Practice Address - Fax:717-715-1302
Is Sole Proprietor?:No
Enumeration Date:2009-05-27
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP010240363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102921010Medicaid
PAPO1739080OtherRAILROAD
PA102921010Medicaid
PA156302Medicare UPIN