Provider Demographics
NPI:1790104297
Name:ALLISON, CHRISTIAN (CNP)
Entity Type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:
Last Name:ALLISON
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:571 MITCHELL ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:GUNTOWN
Mailing Address - State:MS
Mailing Address - Zip Code:38849-8500
Mailing Address - Country:US
Mailing Address - Phone:662-348-3342
Mailing Address - Fax:662-348-2772
Practice Address - Street 1:571 MITCHELL ST
Practice Address - Street 2:SUITE C
Practice Address - City:GUNTOWN
Practice Address - State:MS
Practice Address - Zip Code:38849-8500
Practice Address - Country:US
Practice Address - Phone:662-348-3342
Practice Address - Fax:662-348-2772
Is Sole Proprietor?:No
Enumeration Date:2014-04-11
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR882507363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner