Provider Demographics
NPI:1427864099
Name:SEVERSON, ALLISON KAY (APNP, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:KAY
Last Name:SEVERSON
Suffix:
Gender:F
Credentials:APNP, PMHNP-BC
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:KAY
Other - Last Name:PAITEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:W4671 STARKS RD
Mailing Address - Street 2:
Mailing Address - City:OWEN
Mailing Address - State:WI
Mailing Address - Zip Code:54460-7905
Mailing Address - Country:US
Mailing Address - Phone:715-741-0086
Mailing Address - Fax:
Practice Address - Street 1:W4671 STARKS RD
Practice Address - Street 2:
Practice Address - City:OWEN
Practice Address - State:WI
Practice Address - Zip Code:54460-7905
Practice Address - Country:US
Practice Address - Phone:715-741-0086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15841-33363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI15841-33OtherAPNP LICENSE