Provider Demographics
NPI:1790521029
Name:CULLISON, ALLISON (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:
Last Name:CULLISON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9304 BONITA LN APT 1607
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-0914
Mailing Address - Country:US
Mailing Address - Phone:317-902-3180
Mailing Address - Fax:
Practice Address - Street 1:8401 UNIVERSITY EXEC PARK DR STE 127
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-1358
Practice Address - Country:US
Practice Address - Phone:704-316-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-05
Last Update Date:2024-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC32916183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist