Provider Demographics
NPI:1487279865
Name:GRANT, ALISON (PA-C)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:GRANT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:6160 KEMPSVILLE CIR STE 200A
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-3945
Mailing Address - Country:US
Mailing Address - Phone:757-622-6315
Mailing Address - Fax:757-622-7022
Practice Address - Street 1:4808 COURTHOUSE ST STE 102
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-2684
Practice Address - Country:US
Practice Address - Phone:757-622-6315
Practice Address - Fax:757-622-7022
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-11
Last Update Date:2024-06-24
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant