Individual
ALLISON B TREVILLIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5207 HICKORY PARK DR, SUITE A, GLEN ALLEN, VA 23059-2624
(804) 612-2980
(804) 762-7102
Mailing address
5207 HICKORY PARK DR, SUITE A, GLEN ALLEN, VA 23059-2624
(804) 612-2980
(804) 762-7102
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0001196839
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C06695
GROUP PTAN
VA
01
—
C06778
GROUP PTAN
VA
Enumeration date
06/23/2011
Last updated
02/23/2012
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