Healthcare Provider Details

I. General information

NPI: 1821029380
Provider Name (Legal Business Name): ALLISON ANN BURNAP PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 09/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1672 S COUNTY TRL SUITE 101
EAST GREENWICH RI
02818-1629
US

IV. Provider business mailing address

1672 S COUNTY TRL SUITE 101
EAST GREENWICH RI
02818-1629
US

V. Phone/Fax

Practice location:
  • Phone: 401-885-7546
  • Fax: 401-885-6640
Mailing address:
  • Phone: 401-885-7546
  • Fax: 401-885-6640

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA0073
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: