Provider Demographics
NPI:1255103511
Name:MABE, ALLISON KRISTIN (APRN)
Entity type:Individual
Prefix:MS
First Name:ALLISON
Middle Name:KRISTIN
Last Name:MABE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 BOUGAINVILLEA ST
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-5118
Mailing Address - Country:US
Mailing Address - Phone:202-257-0491
Mailing Address - Fax:
Practice Address - Street 1:1919 BOUGAINVILLEA ST
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-5118
Practice Address - Country:US
Practice Address - Phone:202-257-0491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11029355363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health