Healthcare Provider Details

I. General information

NPI: 1063992469
Provider Name (Legal Business Name): ALLISON J. BURCH NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALLISON J. SCIALLIS

II. Dates (important events)

Enumeration Date: 08/16/2018
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

186 PROVIDENCE ST
WEST WARWICK RI
02893-2508
US

IV. Provider business mailing address

375 ALLENS AVE
PROVIDENCE RI
02905-5010
US

V. Phone/Fax

Practice location:
  • Phone: 401-767-4100
  • Fax:
Mailing address:
  • Phone: 401-444-0400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN03821
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2291004
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: