Basic Information
| Provider Information | |||||||||
| NPI: | 1255812087 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CAHALAN | ||||||||
| FirstName: | ALLISON | ||||||||
| MiddleName: | O'DONNELL | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DNP, AGPCNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2095 WINTERSET DR | ||||||||
| Address2: | |||||||||
| City: | LAKELAND | ||||||||
| State: | FL | ||||||||
| PostalCode: | 338132170 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8636980574 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4315 HIGHLAND PARK BLVD | ||||||||
| Address2: | |||||||||
| City: | LAKELAND | ||||||||
| State: | FL | ||||||||
| PostalCode: | 338131639 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8638165884 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2018 | ||||||||
| LastUpdateDate: | 08/29/2018 | ||||||||
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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 | 363LG0600X | 9360421 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Gerontology |
No ID Information.