Healthcare Provider Details

I. General information

NPI: 1710431127
Provider Name (Legal Business Name): ALLISON KRISTINE MCMICHAEL AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2016
Last Update Date: 09/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2120 SW 22ND PL
OCALA FL
34471-7765
US

IV. Provider business mailing address

1839 QUIET CV
FAYETTEVILLE NC
28304-3857
US

V. Phone/Fax

Practice location:
  • Phone: 352-732-5042
  • Fax: 352-732-6031
Mailing address:
  • Phone: 910-323-1463
  • Fax: 910-323-1575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number12099
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAY2225
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: