Provider Demographics
NPI:1720726151
Name:ST. CYR, ALLISON (AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:ST. CYR
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 TAYLOR CT
Mailing Address - Street 2:
Mailing Address - City:LOCUST GROVE
Mailing Address - State:VA
Mailing Address - Zip Code:22508-5637
Mailing Address - Country:US
Mailing Address - Phone:540-359-2225
Mailing Address - Fax:
Practice Address - Street 1:405 CHATHAM HEIGHTS RD
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22405-2582
Practice Address - Country:US
Practice Address - Phone:540-359-2225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-25
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024183438363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care