Individual
MS. ALLYSSA NICOLE KOERBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3953 S NOVA RD STE B, PORT ORANGE, FL 32127-4910
(386) 788-4911
(844) 388-6186
Mailing address
3953 S NOVA RD STE B, PORT ORANGE, FL 32127-4910
(386) 788-4911
(844) 388-6186
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9115064
FL
363AM0700X
Medical Physician Assistant
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/27/2020
Last updated
10/27/2021
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