Provider Demographics
NPI:1194905935
Name:COLEY, ALLYSON J (CRNP-DNP)
Entity type:Individual
Prefix:
First Name:ALLYSON
Middle Name:J
Last Name:COLEY
Suffix:
Gender:F
Credentials:CRNP-DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 55310
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35255-5310
Mailing Address - Country:US
Mailing Address - Phone:205-731-9701
Mailing Address - Fax:205-297-9411
Practice Address - Street 1:THE KIRKLIN CLINIC
Practice Address - Street 2:2000 6TH AVENUE SOUTH
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35294-0001
Practice Address - Country:US
Practice Address - Phone:205-801-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-09
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-091181363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051118701OtherBCBS
MS09931885Medicaid
AL131012Medicaid
AL051118702OtherBCBS
AL131011Medicaid
AL051118703OtherBCBS
AL130982Medicaid
MS09931885Medicaid