Provider Demographics
NPI:1821571936
Name:CAMP, ALLISON LYNEE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:LYNEE
Last Name:CAMP
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:782 LYMINGTON RD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:OH
Mailing Address - Zip Code:45373-1226
Mailing Address - Country:US
Mailing Address - Phone:937-570-2821
Mailing Address - Fax:
Practice Address - Street 1:1430 W MAIN ST
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-2551
Practice Address - Country:US
Practice Address - Phone:937-335-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-13
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.005668RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant