Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 607332 | TX |
NPI | 1013198605 |
---|---|
Provider Name | Ellen Cathleen Allison |
First Address | Irving, TX 75061-2256 |
Second Address | Irving, TX 75061-2256 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/11/2007 |
Last Update Date | 05/10/2010 |