Provider Demographics
NPI:1659694867
Name:BERARD, ALLISON MICHELLE (PA-C)
Entity Type:Individual
Prefix:MS
First Name:ALLISON
Middle Name:MICHELLE
Last Name:BERARD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:
Other - Last Name:HALLMARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:3044 BRIARCLIFF RD NE
Mailing Address - Street 2:UNIT 4
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-2619
Mailing Address - Country:US
Mailing Address - Phone:770-241-8467
Mailing Address - Fax:
Practice Address - Street 1:340 KENNESTONE HOSPITAL BLVD
Practice Address - Street 2:SUITE LL20
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-3006
Practice Address - Country:US
Practice Address - Phone:770-793-6431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-03
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA005789363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical