Provider Demographics
NPI:1982881157
Name:MARTIN, ALISON R (NP, MSN, APRN-BC)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:R
Last Name:MARTIN
Suffix:
Gender:F
Credentials:NP, MSN, APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9376 ATLEE STATION RD
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-2602
Mailing Address - Country:US
Mailing Address - Phone:804-730-0990
Mailing Address - Fax:804-730-8752
Practice Address - Street 1:9376 ATLEE STATION RD
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-2602
Practice Address - Country:US
Practice Address - Phone:804-730-0990
Practice Address - Fax:804-730-0872
Is Sole Proprietor?:No
Enumeration Date:2008-01-30
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024166646363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA015492V68Medicare PIN
VA015488V21Medicare PIN
VA015490V20Medicare PIN
VA015491V01Medicare PIN