Provider Demographics
NPI:1477275923
Name:ROTH, ALLISON LEIGH (DNP, FNP-C)
Entity type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:LEIGH
Last Name:ROTH
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2818 NW WESTWOOD CT
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-1495
Mailing Address - Country:US
Mailing Address - Phone:515-231-5187
Mailing Address - Fax:
Practice Address - Street 1:1205 COPPER CREEK DR
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:IA
Practice Address - Zip Code:50327-7002
Practice Address - Country:US
Practice Address - Phone:515-262-0404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-12
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAF07221383207Q00000X
IAA170558363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine