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NPI Code Detail

MEDICARE: ALLYSON AVERETT

MEDICARE: ALLYSON AVERETT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0200XPediatric Nurse Practitioner359816NC

General Provider Information

NPI Number : 1023943024
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLYSON AVERETT
Provider Business Mailing Address
First Line : 725 CREEKSIDE DR
Second Line :
City : SANFORD
State : NC
Zip : 27330-9681
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 910 BLACKFORD ST
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37403-1405
Country : US
Telephone Number : 423-778-6011
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2026
Last Update Date : 06/13/2026

Similar Medicare Providers

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1982688065 — DR. CHARLES REECE WOODS JR. MD
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Directions to “ ALLYSON AVERETT ” Practice Location

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