Provider Demographics
NPI:1477162709
Name:STEPHAN, ALISON MCNUTT (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:MCNUTT
Last Name:STEPHAN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MISS
Other - First Name:ALISON
Other - Middle Name:LAUREN
Other - Last Name:MCNUTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:237 AKRON RD
Mailing Address - Street 2:
Mailing Address - City:WADSWORTH
Mailing Address - State:OH
Mailing Address - Zip Code:44281-1970
Mailing Address - Country:US
Mailing Address - Phone:330-612-9310
Mailing Address - Fax:
Practice Address - Street 1:1164 GARMAN RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-6651
Practice Address - Country:US
Practice Address - Phone:330-612-9310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-22
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.404817163W00000X
OHAPRN.CRNA.0020138367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse