Provider Demographics
NPI:1154750743
Name:LEGACY, ALLYSON (APRN)
Entity type:Individual
Prefix:
First Name:ALLYSON
Middle Name:
Last Name:LEGACY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 MCGREGOR ST STE 301
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03102-3734
Mailing Address - Country:US
Mailing Address - Phone:603-314-7246
Mailing Address - Fax:603-314-5937
Practice Address - Street 1:88 MCGREGOR ST STE 301
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102-3734
Practice Address - Country:US
Practice Address - Phone:603-314-7246
Practice Address - Fax:603-314-5937
Is Sole Proprietor?:No
Enumeration Date:2013-11-05
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH040800-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily