Provider Demographics
NPI:1174033401
Name:ALLISON, KRISTI SUE (CNM)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:SUE
Last Name:ALLISON
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3421 W 9TH ST STE G4500
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50702-5401
Mailing Address - Country:US
Mailing Address - Phone:319-272-8200
Mailing Address - Fax:319-272-0400
Practice Address - Street 1:3421 W 9TH ST STE G4500
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50702-5401
Practice Address - Country:US
Practice Address - Phone:319-272-8200
Practice Address - Fax:319-272-0400
Is Sole Proprietor?:No
Enumeration Date:2017-09-29
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAB138272367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife