Basic Information
Provider Information
NPI: 1043930316
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CRUTE
FirstName: ALLISON
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1945 WINDY LEAF CT
Address2:  
City: VIRGINIA BEACH
State: VA
PostalCode: 234563928
CountryCode: US
TelephoneNumber: 7574699283
FaxNumber:  
Practice Location
Address1: 600 GRESHAM DR
Address2:  
City: NORFOLK
State: VA
PostalCode: 235071904
CountryCode: US
TelephoneNumber: 7573883000
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/29/2022
LastUpdateDate: 08/29/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/16/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X0001247704VAY Nursing Service ProvidersRegistered Nurse 

No ID Information.


Home