Healthcare Provider Details

I. General information

NPI: 1265897227
Provider Name (Legal Business Name): ALLISON VOELKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2015
Last Update Date: 03/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

370 E VIRGINIA AVE SUITE 100
PHOENIX AZ
85004-1214
US

IV. Provider business mailing address

370 E VIRGINIA AVE SUITE 100
PHOENIX AZ
85004-1214
US

V. Phone/Fax

Practice location:
  • Phone: 602-258-4788
  • Fax:
Mailing address:
  • Phone: 602-258-4788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number662
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number6343
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: