Provider Demographics
NPI:1013622018
Name:SERVANT, ALANNA (PA-C)
Entity type:Individual
Prefix:
First Name:ALANNA
Middle Name:
Last Name:SERVANT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:280 CHESTNUT STREET
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01199-1001
Mailing Address - Country:US
Mailing Address - Phone:413-794-3909
Mailing Address - Fax:413-794-1629
Practice Address - Street 1:3300 MAIN ST
Practice Address - Street 2:SUITE 4D
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1112
Practice Address - Country:US
Practice Address - Phone:413-794-8336
Practice Address - Fax:413-794-7345
Is Sole Proprietor?:No
Enumeration Date:2023-01-16
Last Update Date:2024-11-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MAPA9191363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical