Provider Demographics
NPI:1457036469
Name:BEAVER, ALLISON MORGAN (PA-C)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:MORGAN
Last Name:BEAVER
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 1:248 JAMISON RD
Mailing Address - Street 2:
Mailing Address - City:MC ALISTERVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17049-8589
Mailing Address - Country:US
Mailing Address - Phone:717-979-3044
Mailing Address - Fax:
Practice Address - Street 1:941 PARK DR
Practice Address - Street 2:
Practice Address - City:PALMYRA
Practice Address - State:PA
Practice Address - Zip Code:17078-3404
Practice Address - Country:US
Practice Address - Phone:717-838-6305
Practice Address - Fax:717-838-5332
Is Sole Proprietor?:No
Enumeration Date:2023-06-19
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PANA207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine