Basic Information
| Provider Information | |||||||||
| NPI: | 1003227513 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CANTRALL | ||||||||
| FirstName: | ALISON | ||||||||
| MiddleName: | T. | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4809 AMBASSADOR CAFFERY PKWY | ||||||||
| Address2: | SUITE 110 | ||||||||
| City: | LAFAYETTE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 705088800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3372357898 | ||||||||
| FaxNumber: | 3372357445 | ||||||||
| Practice Location | |||||||||
| Address1: | 2309 E MAIN ST | ||||||||
| Address2: | SUITE 301 | ||||||||
| City: | NEW IBERIA | ||||||||
| State: | LA | ||||||||
| PostalCode: | 705604046 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3373644415 | ||||||||
| FaxNumber: | 3373644495 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/19/2014 | ||||||||
| LastUpdateDate: | 05/19/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | AP07708 | LA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.