Provider Demographics
NPI:1679036883
Name:STAMPER LEVY, ALISON GRACE (RN, IBCLC)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:GRACE
Last Name:STAMPER LEVY
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 N UPTON ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22207-2326
Mailing Address - Country:US
Mailing Address - Phone:510-316-5104
Mailing Address - Fax:
Practice Address - Street 1:2001 N UPTON ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22207-2326
Practice Address - Country:US
Practice Address - Phone:510-316-5104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-14
Last Update Date:2019-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001262379163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
Provider Identifiers
StateIdentifier IDID TypeIssuer
L-35031OtherNONE
VA0001262379OtherNONE