=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912545757
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALLISON KOLLROSS PA-C, RDN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/11/2019
-----------------------------------------------------
Last Update Date | 05/01/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 509 BILTMORE AVE
-----------------------------------------------------
City | ASHEVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28801-4601
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-213-1111
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 178 GREENVILLE AVE UNIT 306
-----------------------------------------------------
City | ARDEN
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28704-1180
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 608-799-6506
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363AM0700X
-----------------------------------------------------
Taxonomy Name | Medical Physician Assistant
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NULL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 133V00000X
-----------------------------------------------------
Taxonomy Name | Registered Dietitian
-----------------------------------------------------
License Number | 342329
-----------------------------------------------------
License Number State | WI
-----------------------------------------------------