Individual
ALLISON AINSLEY MACKAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1 MEDICAL CENTER DR, LEBANON, NH 03756-0001
(603) 650-5133
Mailing address
1 MEDICAL CENTER DR, LEBANON, NH 03756-0001
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-07569
NC
363AS0400X
Surgical Physician Assistant
Primary
1505
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154846327
—
NC
01
—
397730043
NSC
NC
Enumeration date
08/09/2017
Last updated
08/23/2019
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