Healthcare Provider Details

I. General information

NPI: 1558289876
Provider Name (Legal Business Name): ALLISON MIKITA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 OSTRUM ST
BETHLEHEM PA
18015-1000
US

IV. Provider business mailing address

3905 DAVIS CIR
PLANO TX
75023-5916
US

V. Phone/Fax

Practice location:
  • Phone: 866-785-8537
  • Fax:
Mailing address:
  • Phone: 972-207-9222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA067964
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: