Basic Information
Provider Information
NPI: 1952073686
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BROWNLOW
FirstName: ALLISON
MiddleName: MARIE
NamePrefix: MRS.
NameSuffix:  
Credential: AGACNP-BC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1123 CHESHAM LN
Address2:  
City: GRAND LEDGE
State: MI
PostalCode: 488379740
CountryCode: US
TelephoneNumber: 9899427492
FaxNumber:  
Practice Location
Address1: 1140 E MICHIGAN AVE STE 300
Address2:  
City: LANSING
State: MI
PostalCode: 489121806
CountryCode: US
TelephoneNumber: 5173645200
FaxNumber: 5173645429
Other Information
ProviderEnumerationDate: 09/30/2021
LastUpdateDate: 10/09/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/09/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X4704309586MIN Nursing Service ProvidersRegistered Nurse 
363LA2100X4704309586MIY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care

No ID Information.


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