MEDICARE: ALLYSON LEE STOVALL RN, MSN, PMHNP-BC

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	448229	KY

General Provider Information

NPI Number	:	1205785268
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLYSON LEE STOVALL RN, MSN, PMHNP-BC

Provider Business Mailing Address
First Line	:	PO BOX 56
Second Line	:
City	:	GREENVILLE
State	:	KY
Zip	:	42345-0056
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	316 N MAIN ST
Second Line	:
City	:	GREENVILLE
State	:	KY
Zip	:	42345-1637
Country	:	US
Telephone Number	:	270-377-7137
Fax Number	:

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

Provider Enumeration Date	:	01/23/2026
Last Update Date	:	01/23/2026

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