Provider Demographics
NPI:1811655574
Name:NIEVES, ALISON ROSE
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:ROSE
Last Name:NIEVES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 471
Mailing Address - Street 2:
Mailing Address - City:SUNBURY
Mailing Address - State:PA
Mailing Address - Zip Code:17801-0471
Mailing Address - Country:US
Mailing Address - Phone:866-999-9347
Mailing Address - Fax:
Practice Address - Street 1:800 S 12TH ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-6903
Practice Address - Country:US
Practice Address - Phone:717-273-8170
Practice Address - Fax:717-274-7526
Is Sole Proprietor?:No
Enumeration Date:2021-11-30
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician