Provider Demographics
NPI:1811618150
Name:KERANS, ALISON LEA (APN)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:LEA
Last Name:KERANS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:LEA
Other - Last Name:ST CLAIR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15753 E PAWNEE DR
Mailing Address - Street 2:
Mailing Address - City:CUBA
Mailing Address - State:IL
Mailing Address - Zip Code:61427-9239
Mailing Address - Country:US
Mailing Address - Phone:309-299-4318
Mailing Address - Fax:
Practice Address - Street 1:180 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:IL
Practice Address - Zip Code:61520-2608
Practice Address - Country:US
Practice Address - Phone:309-647-0201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209025900363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health