Provider Demographics
NPI:1609464056
Name:GLEESPEN, ALLYSON BETH
Entity Type:Individual
Prefix:
First Name:ALLYSON
Middle Name:BETH
Last Name:GLEESPEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1091 E CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:OH
Mailing Address - Zip Code:43302-4454
Mailing Address - Country:US
Mailing Address - Phone:740-360-1372
Mailing Address - Fax:
Practice Address - Street 1:1091 E CHURCH ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-4454
Practice Address - Country:US
Practice Address - Phone:740-360-1372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-31
Last Update Date:2020-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide