Provider Demographics
NPI:1275845406
Name:REXRODE, ALLISON DENISE (NP)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:DENISE
Last Name:REXRODE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:DENISE
Other - Last Name:AMANN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9687 PATTERSON CREEK RD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:26710-7363
Mailing Address - Country:US
Mailing Address - Phone:304-813-7320
Mailing Address - Fax:
Practice Address - Street 1:12500 WILLOWBROOK RD
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-6393
Practice Address - Country:US
Practice Address - Phone:240-964-8740
Practice Address - Fax:240-964-8741
Is Sole Proprietor?:No
Enumeration Date:2010-07-02
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR176923363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily