MEDICARE: MRS. ALYSON JUSTICE CRNP

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
1	363LP2300X	Primary Care Nurse Practitioner	1-156221	AL

General Provider Information

NPI Number	:	1396204905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALYSON JUSTICE CRNP

Provider Business Mailing Address
First Line	:	12935 HIGHWAY 231 431 N
Second Line	:
City	:	HAZEL GREEN
State	:	AL
Zip	:	35750-8631
Country	:	US
Telephone Number	:	256-828-6766
Fax Number	:

Provider Business Practice Location Address
First Line	:	420 LOWELL DR SE STE 302
Second Line	:
City	:	HUNTSVILLE
State	:	AL
Zip	:	35801-3762
Country	:	US
Telephone Number	:	256-265-1910
Fax Number	:	256-265-1911

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/14/2019
Last Update Date	:	06/20/2022

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