Provider Demographics
NPI:1265143291
Name:CROSBY, ALLISON MAY
Entity type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:MAY
Last Name:CROSBY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:PRADEEP
Other - Last Name:MANUDHANE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2321 TAYLOR PARK DR # 1104
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-8052
Mailing Address - Country:US
Mailing Address - Phone:614-835-6068
Mailing Address - Fax:
Practice Address - Street 1:4500 ORANGEBERRY DR
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-7924
Practice Address - Country:US
Practice Address - Phone:614-835-6068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-12
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2022067702363LP0808X
OHAPRN.CNP.0032923363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health