Basic Information
Provider Information
NPI: 1154535490
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALLISON
FirstName: JANET
MiddleName:  
NamePrefix: MRS.
NameSuffix:  
Credential: RNC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 14765 FM 2015
Address2:  
City: TYLER
State: TX
PostalCode: 757063120
CountryCode: US
TelephoneNumber: 9038772007
FaxNumber: 9035330726
Practice Location
Address1: 214 E HOUSTON ST
Address2:  
City: TYLER
State: TX
PostalCode: 757028131
CountryCode: US
TelephoneNumber: 9035359041
FaxNumber: 9035330726
Other Information
ProviderEnumerationDate: 05/09/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163WC0400X545953TXY Nursing Service ProvidersRegistered NurseCase Management

No ID Information.


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