Provider Demographics
NPI:1508300542
Name:MAHURIN, ALLISON (RN, BSN)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:MAHURIN
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11309 DONA LOLA DR
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-4320
Mailing Address - Country:US
Mailing Address - Phone:510-495-7761
Mailing Address - Fax:
Practice Address - Street 1:11309 DONA LOLA DR
Practice Address - Street 2:
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91604-4320
Practice Address - Country:US
Practice Address - Phone:510-496-7761
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-09
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA682108163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant