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General NPI Number Information
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NPI Number | 1164605242
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Entity Type | Organization
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Legal Business Name | ALLIANCE CHILDREN'S & ALLIED HEALTH, INC.
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Dates
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Enumeration Date | 12/11/2007
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Last Update Date | 04/22/2015
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Provider Practice Location Address
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Address Line | 2091 BOX BUTTE AVENUE SUITE 600
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City | ALLIANCE
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State | NE
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Zip | 69301-4457
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Country | US
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Telephone | 308-761-1151
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Fax | 308-762-6657
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Provider Business Mailing Address
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Address Line | 204 E 3RD ST
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City | ALLIANCE
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State | NE
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Zip | 69301-3826
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Country | US
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Telephone | 308-761-1151
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Fax | 308-761-1139
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Authorized Official
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Title or Position | OWNER
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Name | JANELL A GRANT
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Credential | ARRN
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Telephone | 308-761-1151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number |
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License Number State |
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