Healthcare Provider Details

I. General information

NPI: 1578407862
Provider Name (Legal Business Name): ALLISON M RALSTON FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4350 7TH ST STE B
MOLINE IL
61265-6870
US

IV. Provider business mailing address

4350 7TH ST STE B
MOLINE IL
61265-6870
US

V. Phone/Fax

Practice location:
  • Phone: 309-517-1180
  • Fax:
Mailing address:
  • Phone: 309-517-1180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041587998
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: