Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 0024172975 | VA |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | AP07523 | LA |
NPI | 1417382433 |
---|---|
Provider Name | Mrs. Allison Robertson |
First Address | Lafayette, LA 70508-5173 |
Second Address | Lynchburg, VA 24502-4272 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/09/2013 |
Last Update Date | 02/08/2021 |