Provider Demographics
NPI:1861131120
Name:BACHMANN, ALLISON
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:BACHMANN
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 1:2330 WEST RD
Mailing Address - Street 2:
Mailing Address - City:WEST RUTLAND
Mailing Address - State:VT
Mailing Address - Zip Code:05777-9240
Mailing Address - Country:US
Mailing Address - Phone:802-855-3796
Mailing Address - Fax:
Practice Address - Street 1:2330 WEST RD
Practice Address - Street 2:
Practice Address - City:WEST RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05777-9240
Practice Address - Country:US
Practice Address - Phone:802-855-3796
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-03
Last Update Date:2022-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant