Healthcare Provider Details

I. General information

NPI: 1821387010
Provider Name (Legal Business Name): ALISON M STOUGHTON CFNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2011
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6220 W MAIN ST
KALAMAZOO MI
49009-8925
US

IV. Provider business mailing address

6938 ELM VALLEY DR
KALAMAZOO MI
49009-7447
US

V. Phone/Fax

Practice location:
  • Phone: 269-276-4744
  • Fax: 269-353-5856
Mailing address:
  • Phone: 269-552-4233
  • Fax: 269-552-4216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704253239
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: