Healthcare Provider Details

I. General information

NPI: 1497138713
Provider Name (Legal Business Name): ALLISON JOY SCHICKERT PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALLISON JOY DESLOOVER PA-C

II. Dates (important events)

Enumeration Date: 07/06/2015
Last Update Date: 12/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4037 NW 86TH TER
GAINESVILLE FL
32606-9277
US

IV. Provider business mailing address

4037 NW 86TH TER
GAINESVILLE FL
32606-9277
US

V. Phone/Fax

Practice location:
  • Phone: 352-265-0820
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: