Healthcare Provider Details

I. General information

NPI: 1659699429
Provider Name (Legal Business Name): ALLISON DEJARNATT PMHNP-BC, ANP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2010
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10130 MALLARD CREEK RD STE 300
CHARLOTTE NC
28262-6001
US

IV. Provider business mailing address

10130 MALLARD CREEK RD STE 300
CHARLOTTE NC
28262-6001
US

V. Phone/Fax

Practice location:
  • Phone: 980-222-1447
  • Fax: 980-500-1066
Mailing address:
  • Phone: 980-222-1447
  • Fax: 980-500-1066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAC005288
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP9187076
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5010263
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number334814
License Number StateAZ
# 5
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1136449
License Number StateTX
# 6
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberSP031626
License Number StatePA
# 7
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number33404
License Number StateTN
# 8
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number5010263
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: