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Individual
ALLISON ELISE CHURCH
Active
Individual
ALLISON ELISE CHURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10003634A
IN
363A00000X
Physician Assistant
5601008132
MI
363A00000X
Physician Assistant
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1102298260
ANTHEM PTAN
IN
05
—
300067817
—
IN
Enumeration date
03/23/2015
Last updated
02/10/2025
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