Healthcare Provider Details

I. General information

NPI: 1386564086
Provider Name (Legal Business Name): ALLISON NICOLE POZEGA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5722 CABIN CREEK RD
DAWES WV
25054-7700
US

IV. Provider business mailing address

104 ALEX LN
CHARLESTON WV
25304-2952
US

V. Phone/Fax

Practice location:
  • Phone: 304-595-5006
  • Fax:
Mailing address:
  • Phone: 304-595-5006
  • Fax: 888-987-8901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number102104
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: