Provider Demographics
NPI:1730926536
Name:BOLLONE, ALANA (PA)
Entity type:Individual
Prefix:
First Name:ALANA
Middle Name:
Last Name:BOLLONE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:1820 JEWEL SISSON DR UNIT 207
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62223-3569
Mailing Address - Country:US
Mailing Address - Phone:618-540-9912
Mailing Address - Fax:
Practice Address - Street 1:4802 S STATE ROUTE 159
Practice Address - Street 2:
Practice Address - City:GLEN CARBON
Practice Address - State:IL
Practice Address - Zip Code:62034-1904
Practice Address - Country:US
Practice Address - Phone:618-288-4388
Practice Address - Fax:618-288-7660
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-10
Last Update Date:2024-10-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL085.010693363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant