Provider Demographics
NPI:1841597572
Name:ALLISON-FECTEAU, NATHALIE Z (PA-C)
Entity Type:Individual
Prefix:
First Name:NATHALIE
Middle Name:Z
Last Name:ALLISON-FECTEAU
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 1:6140 W ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-8409
Mailing Address - Country:US
Mailing Address - Phone:561-498-4407
Mailing Address - Fax:561-498-4480
Practice Address - Street 1:6140 W ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484
Practice Address - Country:US
Practice Address - Phone:561-498-4407
Practice Address - Fax:561-498-4480
Is Sole Proprietor?:No
Enumeration Date:2011-02-15
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9105678363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant