Provider Demographics
NPI:1215790209
Name:GILLIS, ALISON ANN (ACNPC-AG)
Entity type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:ANN
Last Name:GILLIS
Suffix:
Gender:F
Credentials:ACNPC-AG
Other - Prefix:MISS
Other - First Name:ALISON
Other - Middle Name:ANN
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AGNPC-AG, ARNP
Mailing Address - Street 1:701 10TH ST SE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52403-1292
Mailing Address - Country:US
Mailing Address - Phone:319-861-7684
Mailing Address - Fax:
Practice Address - Street 1:788 8TH AVE SE STE 200
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52401-2106
Practice Address - Country:US
Practice Address - Phone:319-221-8788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-01
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAH177846363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care