Provider Demographics
NPI:1306084694
Name:ALLISON, BETH FRANCES (PA)
Entity type:Individual
Prefix:MRS
First Name:BETH
Middle Name:FRANCES
Last Name:ALLISON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MRS
Other - First Name:BETH
Other - Middle Name:FRANCES
Other - Last Name:SHIFFNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:1184 LENA LN
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34240-9747
Mailing Address - Country:US
Mailing Address - Phone:941-302-4108
Mailing Address - Fax:
Practice Address - Street 1:1750 17TH ST STE E
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34234-8666
Practice Address - Country:US
Practice Address - Phone:941-529-0202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-26
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA2639363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL291676200Medicaid