MEDICARE: ANDREW ALLISON APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	888930	NV

General Provider Information

NPI Number	:	1144017542
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW ALLISON APRN

Provider Business Mailing Address
First Line	:	452 E SILVERADO RANCH BLVD # 213
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89183-6210
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	452 E SILVERADO RANCH BLVD # 213
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89183-6210
Country	:	US
Telephone Number	:	508-212-1388
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/21/2025
Last Update Date	:	05/18/2026

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