Healthcare Provider Details

I. General information

NPI: 1235892951
Provider Name (Legal Business Name): ALISON ROSE DOUGLAS APRN, ACNPC-AG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ALISON ROSE CARPENTER RN

II. Dates (important events)

Enumeration Date: 10/19/2021
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

591 REDMOND RD NW STE 203
ROME GA
30165-1415
US

IV. Provider business mailing address

PO BOX 12938 C/O CLINIC MANAGEMENT
CALHOUN GA
30703-7013
US

V. Phone/Fax

Practice location:
  • Phone: 706-528-9060
  • Fax: 706-528-9061
Mailing address:
  • Phone: 706-602-7800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN-NP247674
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN-NP247674
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: