Provider Demographics
NPI:1326698697
Name:VANKEUREN, ALLISON (RN)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:VANKEUREN
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 1:515 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:PENN YAN
Mailing Address - State:NY
Mailing Address - Zip Code:14527-1024
Mailing Address - Country:US
Mailing Address - Phone:315-536-7255
Mailing Address - Fax:315-279-1245
Practice Address - Street 1:515 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:PENN YAN
Practice Address - State:NY
Practice Address - Zip Code:14527-1024
Practice Address - Country:US
Practice Address - Phone:315-536-7255
Practice Address - Fax:315-279-1245
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-18
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY645626163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WS0200XNursing Service ProvidersRegistered NurseSchoolGroup - Single Specialty