Provider Demographics
NPI:1770719833
Name:TEMPLE, ALISON LAVONNE (PA-C)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:LAVONNE
Last Name:TEMPLE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:LAVONNE
Other - Last Name:SALERNO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1705 GARDNER DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28405-8873
Mailing Address - Country:US
Mailing Address - Phone:910-343-5300
Mailing Address - Fax:910-254-1352
Practice Address - Street 1:1705 GARDNER DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28405-8873
Practice Address - Country:US
Practice Address - Phone:910-343-5300
Practice Address - Fax:910-254-1352
Is Sole Proprietor?:No
Enumeration Date:2009-06-03
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant