Provider Demographics
NPI:1306335641
Name:HENRY, ALLISON LOUISE
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:LOUISE
Last Name:HENRY
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 1:3109 ANTHONY DR
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75092-3406
Mailing Address - Country:US
Mailing Address - Phone:903-821-4182
Mailing Address - Fax:
Practice Address - Street 1:3109 ANTHONY DR
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-3406
Practice Address - Country:US
Practice Address - Phone:903-821-4182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-02
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX339148164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse