Provider Demographics
NPI:1336780105
Name:ARENDS, ALLISON (NP)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:ARENDS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:285 W CROFTON HALL RD
Mailing Address - Street 2:
Mailing Address - City:STURGEON
Mailing Address - State:MO
Mailing Address - Zip Code:65284-4701
Mailing Address - Country:US
Mailing Address - Phone:573-823-4227
Mailing Address - Fax:
Practice Address - Street 1:3220 BLUFF CREEK DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-3663
Practice Address - Country:US
Practice Address - Phone:573-443-8773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-03
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO363LG0600X363LG0600X
MO2019038069363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology