Provider Demographics
NPI:1114114212
Name:ALLISON, CARLA J (RN)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:J
Last Name:ALLISON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1022 KAY LYNN ST
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-2006
Mailing Address - Country:US
Mailing Address - Phone:817-477-3048
Mailing Address - Fax:817-477-3330
Practice Address - Street 1:1022 KAY LYNN ST
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-2006
Practice Address - Country:US
Practice Address - Phone:817-477-3048
Practice Address - Fax:817-477-3330
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-02
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX608031163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics