Healthcare Provider Details

I. General information

NPI: 1578930574
Provider Name (Legal Business Name): MICHELLE DUNCAN ALLISON APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2015
Last Update Date: 08/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 E ROBINSON ST
GAFFNEY SC
29340-2444
US

IV. Provider business mailing address

250 DEWEY AVE
SPARTANBURG SC
29303-3009
US

V. Phone/Fax

Practice location:
  • Phone: 864-487-2710
  • Fax: 864-487-2729
Mailing address:
  • Phone: 864-585-0366
  • Fax: 864-487-2729

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number236772
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number23079
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: