Healthcare Provider Details

I. General information

NPI: 1144981358
Provider Name (Legal Business Name): ALLISON SKREZEC NP IN FAMILY HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2022
Last Update Date: 08/23/2023
Certification Date: 08/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54075 MAIN RD
SOUTHHOLD NY
11971
US

IV. Provider business mailing address

PO BOX 170
OZARK AR
72949-0170
US

V. Phone/Fax

Practice location:
  • Phone: 631-765-8746
  • Fax: 631-765-8747
Mailing address:
  • Phone: 866-243-7203
  • Fax: 866-217-9330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ALLISON SKREZEC
Title or Position: OWNER
Credential: APRN
Phone: 479-343-9916