Healthcare Provider Details

I. General information

NPI: 1174781553
Provider Name (Legal Business Name): ALISHA JANELLE GRAYSON APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. ALISHA JANELLE NAPIER

II. Dates (important events)

Enumeration Date: 06/02/2008
Last Update Date: 04/10/2024
Certification Date: 04/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

828 WASHINGTON AVE
HUNGTINGON WV
25704
US

IV. Provider business mailing address

828 WASHINGTON AVE
HUNGTINGON WV
25704
US

V. Phone/Fax

Practice location:
  • Phone: 304-529-0466
  • Fax: 304-529-0466
Mailing address:
  • Phone: 304-529-0466
  • Fax: 304-529-0466

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number105808
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704412843
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number105808
License Number StateWV
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0027650
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number52323
License Number StateWV
# 6
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number105808
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: