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General NPI Number Information
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NPI Number | 1467518811
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Entity Type | Individual
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Provider Name | MARY ALICE ALLCOTT NP
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Gender | Female
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 04/22/2015
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Provider Practice Location Address
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Address Line | 510 EAST OGLETHORPE HIGHWAY
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City | HINESVILLE
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State | GA
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Zip | 31313-2825
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Country | US
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Telephone | 912-369-7546
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Fax | 912-876-3396
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Provider Business Mailing Address
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Address Line | 2400 BELLEVUE RD SUITE 21-A
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City | DUBLIN
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State | GA
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Zip | 31021-2885
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Country | US
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Telephone | 478-275-7202
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Fax | 478-274-8418
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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 | RN052669
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | RN052669
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | RN052669
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN052669
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License Number State | GA
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