Provider Demographics
NPI:1932658374
Name:BARRETT, ALLISON (CRNA)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:BARRETT
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:
Other - Last Name:ATCHOO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:749 COLUMBIA RD
Mailing Address - Street 2:
Mailing Address - City:BERKLEY
Mailing Address - State:MI
Mailing Address - Zip Code:48072-1960
Mailing Address - Country:US
Mailing Address - Phone:248-933-1552
Mailing Address - Fax:
Practice Address - Street 1:749 COLUMBIA RD
Practice Address - Street 2:
Practice Address - City:BERKLEY
Practice Address - State:MI
Practice Address - Zip Code:48072-1960
Practice Address - Country:US
Practice Address - Phone:248-933-1552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-27
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704276406367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered