Healthcare Provider Details

I. General information

NPI: 1164144952
Provider Name (Legal Business Name): ALLYSON CARRIER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2022
Last Update Date: 11/10/2022
Certification Date: 11/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 GROVE ST
NEW BRITAIN CT
06053-4116
US

IV. Provider business mailing address

184 BURLINGTON AVE
BRISTOL CT
06010-3678
US

V. Phone/Fax

Practice location:
  • Phone: 860-224-2447
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number10741
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number10741
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number127754
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: