Provider Demographics
NPI:1083478051
Name:BAKEWELL, ALLISON
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:BAKEWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 ROUTE 27
Mailing Address - Street 2:
Mailing Address - City:RAYMOND
Mailing Address - State:NH
Mailing Address - Zip Code:03077-1230
Mailing Address - Country:US
Mailing Address - Phone:603-895-3351
Mailing Address - Fax:
Practice Address - Street 1:128 ROUTE 27
Practice Address - Street 2:
Practice Address - City:RAYMOND
Practice Address - State:NH
Practice Address - Zip Code:03077-1230
Practice Address - Country:US
Practice Address - Phone:603-895-3351
Practice Address - Fax:603-659-5892
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-09
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH111215-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily