Provider Demographics
NPI:1093526915
Name:STGERMAIN, ALISON M
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:M
Last Name:STGERMAIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2647 UNION DRIVE THIELEN STUDENT HEALTH CENTER
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50011-0001
Mailing Address - Country:US
Mailing Address - Phone:515-294-7713
Mailing Address - Fax:
Practice Address - Street 1:2647 UNION DRIVE THIELEN STUDENT HEALTH CENTER
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50011-0001
Practice Address - Country:US
Practice Address - Phone:515-294-7713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-20
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01199133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered