Provider Demographics
NPI:1942068549
Name:BELLOWS, ALLISON JANET
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:JANET
Last Name:BELLOWS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:JANET
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3136 BLACKWATER OAKS WAY
Mailing Address - Street 2:
Mailing Address - City:MULBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:33860-5551
Mailing Address - Country:US
Mailing Address - Phone:863-804-1442
Mailing Address - Fax:
Practice Address - Street 1:3136 BLACKWATER OAKS WAY
Practice Address - Street 2:
Practice Address - City:MULBERRY
Practice Address - State:FL
Practice Address - Zip Code:33860-5551
Practice Address - Country:US
Practice Address - Phone:863-804-1442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-08
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11031358363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily