Healthcare Provider Details

I. General information

NPI: 1215316401
Provider Name (Legal Business Name): ALLISON MARIE CRALL ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALLISON MARIE GOURLEY

II. Dates (important events)

Enumeration Date: 05/21/2015
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

921 PENNSYLVANIA AVE
OTTUMWA IA
52501-2138
US

IV. Provider business mailing address

921 PENNSYLVANIA AVE
OTTUMWA IA
52501-2138
US

V. Phone/Fax

Practice location:
  • Phone: 641-931-4966
  • Fax: 641-682-5584
Mailing address:
  • Phone: 641-931-4966
  • Fax: 641-682-5584

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA126436
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberA126436
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: