Provider Demographics
NPI:1851986871
Name:HUPP, ALLISON R (APRNCNP)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:R
Last Name:HUPP
Suffix:
Gender:F
Credentials:APRNCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 CALIFORNIA AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44641-8737
Mailing Address - Country:US
Mailing Address - Phone:330-693-5021
Mailing Address - Fax:330-693-5022
Practice Address - Street 1:159 POPLAR ST NW
Practice Address - Street 2:
Practice Address - City:BOLIVAR
Practice Address - State:OH
Practice Address - Zip Code:44612-9208
Practice Address - Country:US
Practice Address - Phone:133-066-3140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-02
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0028357363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily