Individual
AMANDA RAE ALLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-C
Contact information
Practice address
4130 DUTCHMANS LN STE 300, LOUISVILLE, KY 40207-4710
(502) 897-1794
(502) 897-3852
Mailing address
4130 DUTCHMANS LN STE 300, LOUISVILLE, KY 40207-4710
(502) 897-1794
(502) 897-3852
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3013010
KY
363LF0000X
Family Nurse Practitioner
3013010
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300041654
—
IN
01
—
3013010
KY APRN LICENSE
KY
05
—
7100655180
—
KY
01
—
71010228A
IN APRN LICENSE
IN
Enumeration date
01/08/2019
Last updated
08/27/2020
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