Provider Demographics
NPI:1952897837
Name:ALLISON, GEORGE A (LPN)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:A
Last Name:ALLISON
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1744 WYOMING AVE
Mailing Address - Street 2:
Mailing Address - City:EAST LIVERPOOL
Mailing Address - State:OH
Mailing Address - Zip Code:43920-1575
Mailing Address - Country:US
Mailing Address - Phone:330-385-6576
Mailing Address - Fax:
Practice Address - Street 1:9955 UNION RIDGE RD
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:OH
Practice Address - Zip Code:44455-9763
Practice Address - Country:US
Practice Address - Phone:330-953-0243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-03
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH142808164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse