Provider Demographics
NPI:1740393800
Name:KILLEEN, ALLISON M (RN, PNP)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:M
Last Name:KILLEEN
Suffix:
Gender:F
Credentials:RN, PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 THOMAS JEFFERSON LN
Mailing Address - Street 2:
Mailing Address - City:SNYDER
Mailing Address - State:NY
Mailing Address - Zip Code:14226-3825
Mailing Address - Country:US
Mailing Address - Phone:716-839-5225
Mailing Address - Fax:
Practice Address - Street 1:104 THOMAS JEFFERSON LN
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-3825
Practice Address - Country:US
Practice Address - Phone:716-839-5225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY419513-1163W00000X
NYF380914-1363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse