Provider Demographics
NPI:1467244699
Name:SMITH, ALLISON THERESA (PA)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:THERESA
Last Name:SMITH
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 1:18514 ACADIANA PL
Mailing Address - Street 2:
Mailing Address - City:LORANGER
Mailing Address - State:LA
Mailing Address - Zip Code:70446-2466
Mailing Address - Country:US
Mailing Address - Phone:985-517-5489
Mailing Address - Fax:
Practice Address - Street 1:18514 ACADIANA PL
Practice Address - Street 2:
Practice Address - City:LORANGER
Practice Address - State:LA
Practice Address - Zip Code:70446-2466
Practice Address - Country:US
Practice Address - Phone:985-517-5489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-22
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant