Provider Demographics
NPI:1891732491
Name:ALLISON, JAN (FNP)
Entity Type:Individual
Prefix:
First Name:JAN
Middle Name:
Last Name:ALLISON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2618
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28793-2618
Mailing Address - Country:US
Mailing Address - Phone:828-693-4431
Mailing Address - Fax:828-693-4434
Practice Address - Street 1:510 BALSAM RD
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-5703
Practice Address - Country:US
Practice Address - Phone:828-693-4431
Practice Address - Fax:828-693-4434
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201351363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7003807Medicaid
NC7003807Medicaid