Provider Demographics
NPI:1861103939
Name:APPLEGATE, ALLYSON PAIGE
Entity type:Individual
Prefix:
First Name:ALLYSON
Middle Name:PAIGE
Last Name:APPLEGATE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1595
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41105-1595
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:912 PARK AVE
Practice Address - Street 2:
Practice Address - City:IRONTON
Practice Address - State:OH
Practice Address - Zip Code:45638-1596
Practice Address - Country:US
Practice Address - Phone:740-532-1100
Practice Address - Fax:740-534-0029
Is Sole Proprietor?:No
Enumeration Date:2022-12-09
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3017508363LF0000X
OH0030883363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily