Provider Demographics
NPI:1073563839
Name:SASSEEN, ALISON CAROL (ARNP, APN)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:CAROL
Last Name:SASSEEN
Suffix:
Gender:F
Credentials:ARNP, APN
Other - Prefix:MS
Other - First Name:ALISON
Other - Middle Name:CAROL
Other - Last Name:CHILDRESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:300 S 8TH ST
Mailing Address - Street 2:SUITE 480W
Mailing Address - City:MURRAY
Mailing Address - State:KY
Mailing Address - Zip Code:42071-2400
Mailing Address - Country:US
Mailing Address - Phone:270-762-1597
Mailing Address - Fax:270-752-2860
Practice Address - Street 1:803 POPLAR ST
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-2432
Practice Address - Country:US
Practice Address - Phone:270-762-1597
Practice Address - Fax:270-752-2860
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4564P363LF0000X
TNAPN0000011683363LF0000X
KY3004564363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78017191Medicaid
KY78017191Medicaid
KY78017191Medicaid
TN3643521Medicare PIN
KY0910606Medicare PIN
KYP00325559Medicare PIN
TN1404016OtherBCBC OF TN
KY78017191Medicaid
0910606OtherUMWA FUNDS
KYQ43920Medicare UPIN
113290OtherHEALTH ALLIANCE
KY736265OtherCHA HEALTH
KY0910606OtherUMWA
KY54730OtherBLUEGRASS FAMILY HEALTH
KY736265OtherHEALTH LINK