Provider Demographics
NPI:1396204905
Name:JUSTICE, ALYSON (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:ALYSON
Middle Name:
Last Name:JUSTICE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12935 HIGHWAY 231 431 N
Mailing Address - Street 2:
Mailing Address - City:HAZEL GREEN
Mailing Address - State:AL
Mailing Address - Zip Code:35750-8631
Mailing Address - Country:US
Mailing Address - Phone:256-828-6766
Mailing Address - Fax:
Practice Address - Street 1:420 LOWELL DR SE STE 302
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-3762
Practice Address - Country:US
Practice Address - Phone:256-265-1910
Practice Address - Fax:256-265-1911
Is Sole Proprietor?:No
Enumeration Date:2019-03-14
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-156221363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care