Provider Demographics
NPI:1669477378
Name:ZELENAK, ALLISON W (PA-C)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:W
Last Name:ZELENAK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:C
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 13605
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27415-3605
Mailing Address - Country:US
Mailing Address - Phone:336-832-9943
Mailing Address - Fax:336-832-8272
Practice Address - Street 1:2704 HENRY ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-3633
Practice Address - Country:US
Practice Address - Phone:336-621-3777
Practice Address - Fax:336-621-8374
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2008-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC103693363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2759359AMedicare PIN
NCP98822Medicare UPIN