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General NPI Number Information
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NPI Number | 1639543721
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Entity Type | Individual
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Provider Name | ALISHA J. KOLLE CPNP-AC
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Gender | Female
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Dates
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Enumeration Date | 11/30/2015
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Last Update Date | 12/29/2022
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Provider Practice Location Address
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Address Line | 502 GOVERNORS DR SW
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City | HUNTSVILLE
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State | AL
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Zip | 35801-5126
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Country | US
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Telephone | 256-533-0833
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Fax | 256-533-0833
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Provider Business Mailing Address
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Address Line | 28765 AL HIGHWAY 53
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City | ARDMORE
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State | AL
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Zip | 35739-8709
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Country | US
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Telephone | 256-777-6310
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Fax |
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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 | 363LP0222X
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Taxonomy Name | Critical Care Pediatric Nurse Practitioner
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License Number | 20732
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 1-132523
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License Number State | AL
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