Provider Demographics
NPI:1346759974
Name:ALLISON, NEVA R (NP-C)
Entity Type:Individual
Prefix:MS
First Name:NEVA
Middle Name:R
Last Name:ALLISON
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6085 OLD NATIONAL HWY STE G
Mailing Address - Street 2:
Mailing Address - City:SOUTH FULTON
Mailing Address - State:GA
Mailing Address - Zip Code:30349-4333
Mailing Address - Country:US
Mailing Address - Phone:470-754-6360
Mailing Address - Fax:877-780-7359
Practice Address - Street 1:6085 OLD NATIONAL HWY STE G
Practice Address - Street 2:
Practice Address - City:SOUTH FULTON
Practice Address - State:GA
Practice Address - Zip Code:30349-4333
Practice Address - Country:US
Practice Address - Phone:470-754-6360
Practice Address - Fax:877-780-7359
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-26
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN250913363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAG325565196OtherMEDICARE
GA003207772CMedicaid