Provider Demographics
NPI:1285266635
Name:CARDONA, ALLYSSA VICTORIA (PA-C)
Entity type:Individual
Prefix:
First Name:ALLYSSA
Middle Name:VICTORIA
Last Name:CARDONA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ALLYSSA
Other - Middle Name:VICTORIA COLEMAN
Other - Last Name:DENNARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:731 DOGWOOD RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806
Mailing Address - Country:US
Mailing Address - Phone:828-210-9300
Mailing Address - Fax:828-210-9319
Practice Address - Street 1:731 DOGWOOD RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806
Practice Address - Country:US
Practice Address - Phone:828-210-9300
Practice Address - Fax:828-210-9319
Is Sole Proprietor?:No
Enumeration Date:2020-02-04
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-09757363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant