Provider Demographics
NPI:1912335688
Name:BETH ALLISON FNP LLC
Entity type:Organization
Organization Name:BETH ALLISON FNP LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BETH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ALLISON
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:412-889-8297
Mailing Address - Street 1:2055 EXCHANGE ST STE 270
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:OR
Mailing Address - Zip Code:97103-3419
Mailing Address - Country:US
Mailing Address - Phone:503-325-7546
Mailing Address - Fax:503-325-7343
Practice Address - Street 1:2055 EXCHANGE ST STE 270
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:OR
Practice Address - Zip Code:97103-3419
Practice Address - Country:US
Practice Address - Phone:503-325-7546
Practice Address - Fax:503-325-7343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-16
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200850149NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty