Provider Demographics
NPI:1124742895
Name:ST. JOHN, ALLISON T (FNP)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:T
Last Name:ST. JOHN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4243 S MARTINGALE RD
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-8396
Mailing Address - Country:US
Mailing Address - Phone:302-598-4189
Mailing Address - Fax:
Practice Address - Street 1:4365 E PECOS RD UNIT 117
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-7875
Practice Address - Country:US
Practice Address - Phone:302-598-4189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-27
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ281496363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily