Provider Demographics
NPI:1245849454
Name:DUVALL, ALISON TRAUTMAN
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:TRAUTMAN
Last Name:DUVALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:MARIE
Other - Last Name:TRAUTMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2207 POCAHONTAS TRL
Mailing Address - Street 2:
Mailing Address - City:QUINTON
Mailing Address - State:VA
Mailing Address - Zip Code:23141-1633
Mailing Address - Country:US
Mailing Address - Phone:804-932-4336
Mailing Address - Fax:804-932-8963
Practice Address - Street 1:2207 POCAHONTAS TRL
Practice Address - Street 2:
Practice Address - City:QUINTON
Practice Address - State:VA
Practice Address - Zip Code:23141-1633
Practice Address - Country:US
Practice Address - Phone:804-932-4336
Practice Address - Fax:804-932-8963
Is Sole Proprietor?:No
Enumeration Date:2020-07-24
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202218865183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist