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General NPI Number Information
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NPI Number | 1417414178
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Entity Type | Individual
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Provider Name | ALLISON ALLSBURY FNP
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Gender | Female
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Dates
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Enumeration Date | 02/28/2019
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Last Update Date | 01/31/2022
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Provider Practice Location Address
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Address Line | 9400 E 350
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City | RAYTOWN
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State | MO
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Zip | 64133-6509
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Country | US
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Telephone | 816-251-5700
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Fax | 816-251-5701
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Provider Business Mailing Address
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Address Line | PO BOX 504938
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City | SAINT LOUIS
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State | MO
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Zip | 63150-4938
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Country | US
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Telephone | 816-599-9499
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Fax | 816-932-9670
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2019012586
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License Number State | MO
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