Provider Demographics
NPI:1740685635
Name:BAUER, ALLISON LEIGH DELISLE (NP)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:LEIGH DELISLE
Last Name:BAUER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:L
Other - Last Name:DELISLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1815 PEARL ST
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2880
Mailing Address - Country:US
Mailing Address - Phone:256-426-5050
Mailing Address - Fax:
Practice Address - Street 1:1240 S CEDAR CREST BLVD STE 308
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6370
Practice Address - Country:US
Practice Address - Phone:106-402-1350
Practice Address - Fax:610-402-9799
Is Sole Proprietor?:No
Enumeration Date:2014-11-04
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN19081363LF0000X
PASP020760363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily