Provider Demographics
NPI:1568027837
Name:KANE, ALICIA PIRRALLO (DNP)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:PIRRALLO
Last Name:KANE
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 GROVE RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605-4656
Mailing Address - Country:US
Mailing Address - Phone:864-455-8897
Mailing Address - Fax:
Practice Address - Street 1:1120 GROVE RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4656
Practice Address - Country:US
Practice Address - Phone:864-455-8897
Practice Address - Fax:864-455-8555
Is Sole Proprietor?:No
Enumeration Date:2019-05-02
Last Update Date:2023-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC22794363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily