Doctor Name: | TEAGAN ALLISON |
NPI Number: | 1013319904 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | 4704260252 |
Business Practice Address: | 601 John St Suite M 124 Kalamazoo, MI - 490075341 |
Business Phone Number: | 2693417500 |
Business Fax Number: | 2693417540 |
Mailing Address: | 601 John St, Suite M 124 KALAMAZOO |
State: | MI |
Postal Code: | 490075341 |
Phone Number: | 2693417500 |
Fax Number: | 2693417540 |
NPI Enumeration Date: | 09/23/2014 |
NPI Last Update Date: | 11/18/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 4704260252 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |