Provider Demographics
NPI:1902259153
Name:ELIASON, ALLISON MEGAN (CRNP)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:MEGAN
Last Name:ELIASON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:MEGAN
Other - Last Name:MORA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:1331 HULL ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21230-5243
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2149 S QUEEN ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-4845
Practice Address - Country:US
Practice Address - Phone:717-356-4460
Practice Address - Fax:717-260-3326
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-22
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR201043363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily