Healthcare Provider Details

I. General information

NPI: 1295965002
Provider Name (Legal Business Name): ALISON KROUPA LEES ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2009
Last Update Date: 11/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10201 ARCOS AVE SUITE 203
ESTERO FL
33928-9459
US

IV. Provider business mailing address

10201 ARCOS AVE SUITE 203
ESTERO FL
33928-9459
US

V. Phone/Fax

Practice location:
  • Phone: 239-390-3376
  • Fax: 239-333-0474
Mailing address:
  • Phone: 239-390-3376
  • Fax: 239-333-0474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP 9195796
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: