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General NPI Number Information
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NPI Number | 1881829380
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Entity Type | Individual
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Provider Name | KELLIE A ALLISON ETC.
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Gender | Female
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Dates
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Enumeration Date | 05/27/2009
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Last Update Date | 05/27/2009
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Provider Practice Location Address
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Address Line | 1008 TRAILWOOD DR
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City | HEBER SPRINGS
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State | AR
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Zip | 72543-9212
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Country | US
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Telephone | 501-250-7039
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Fax |
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Provider Business Mailing Address
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Address Line | 1503 W SCOTT ST
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City | HEBER SPRINGS
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State | AR
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Zip | 72543-3510
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Country | US
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Telephone | 501-206-4514
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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 | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | 050109850206E
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License Number State | AR
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