Provider Demographics
NPI:1154600526
Name:FOSNIGHT, ALEECE RENEE (PA)
Entity type:Individual
Prefix:
First Name:ALEECE
Middle Name:RENEE
Last Name:FOSNIGHT
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 YORKSHIRE ST STE D
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-2768
Mailing Address - Country:US
Mailing Address - Phone:828-724-7166
Mailing Address - Fax:828-724-7165
Practice Address - Street 1:6 YORKSHIRE ST STE D
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-2768
Practice Address - Country:US
Practice Address - Phone:828-724-7166
Practice Address - Fax:828-724-7165
Is Sole Proprietor?:No
Enumeration Date:2011-08-16
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
NC0010-03053363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNC2553COtherMEDICARE PTAN
NCNC2553AOtherMEDICARE PTAN