Healthcare Provider Details
I. General information
NPI: 1649970963
Provider Name (Legal Business Name): ALLISON ELAINE MEHLMANN CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/06/2023
Last Update Date: 06/06/2023
Certification Date: 06/06/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1525 S COOPER ST
ARLINGTON TX
76010-4105
US
IV. Provider business mailing address
PO BOX 733784
DALLAS TX
75373-3784
US
V. Phone/Fax
- Phone: 817-804-1100
- Fax:
- Phone: 682-885-6483
- Fax: 682-885-3113
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0200X |
| Taxonomy | Pediatric Nurse Practitioner |
| License Number | 1103894 |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP2300X |
| Taxonomy | Primary Care Nurse Practitioner |
| License Number | 1103894 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: