Provider Demographics
NPI:1396761615
Name:MORRISON, ALISON ROTH (PNP)
Entity type:Individual
Prefix:MS
First Name:ALISON
Middle Name:ROTH
Last Name:MORRISON
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
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Mailing Address - Street 1:456 N NEW BALLAS RD STE 304
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-6846
Mailing Address - Country:US
Mailing Address - Phone:314-567-6868
Mailing Address - Fax:314-567-0578
Practice Address - Street 1:456 N NEW BALLAS RD
Practice Address - Street 2:
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-6831
Practice Address - Country:US
Practice Address - Phone:314-567-6868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000166846363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO420633208Medicaid
MO420633208Medicaid