Provider Demographics
NPI:1700491594
Name:ALFORD, AUDREY (RN,BSN)
Entity Type:Individual
Prefix:
First Name:AUDREY
Middle Name:
Last Name:ALFORD
Suffix:
Gender:F
Credentials:RN,BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 PLAZA DR STE N
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-8735
Mailing Address - Country:US
Mailing Address - Phone:740-275-2182
Mailing Address - Fax:
Practice Address - Street 1:107 PLAZA DR STE N
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-8735
Practice Address - Country:US
Practice Address - Phone:740-449-2879
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-09
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.45529163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health