Provider Demographics
NPI:1578348504
Name:OLEWINE, ALYSSA MARIE (PA-C)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:MARIE
Last Name:OLEWINE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3940 LOCUST LN
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17109-4023
Mailing Address - Country:US
Mailing Address - Phone:800-245-7277
Mailing Address - Fax:
Practice Address - Street 1:38 N 4TH ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18102-3448
Practice Address - Country:US
Practice Address - Phone:610-782-3270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-28
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant