Provider Demographics
NPI:1891090106
Name:GERRISH, ALISON A (PA-C)
Entity Type:Individual
Prefix:MS
First Name:ALISON
Middle Name:A
Last Name:GERRISH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MRS
Other - First Name:ALISON
Other - Middle Name:A
Other - Last Name:SCHRAMM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:701 PARK AVE
Mailing Address - Street 2:P5
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55415-1623
Mailing Address - Country:US
Mailing Address - Phone:612-873-9705
Mailing Address - Fax:612-873-9264
Practice Address - Street 1:701 PARK AVE
Practice Address - Street 2:P5
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55415-1623
Practice Address - Country:US
Practice Address - Phone:612-873-8701
Practice Address - Fax:612-904-4296
Is Sole Proprietor?:No
Enumeration Date:2011-01-18
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1519363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant