Provider Demographics
NPI:1386908952
Name:BIRD, ALISON RACHEL (APRN, CPNP)
Entity type:Individual
Prefix:MISS
First Name:ALISON
Middle Name:RACHEL
Last Name:BIRD
Suffix:
Gender:F
Credentials:APRN, CPNP
Other - Prefix:MISS
Other - First Name:ALISON
Other - Middle Name:RACHEL
Other - Last Name:MCBRIDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN, CPNP
Mailing Address - Street 1:134 S WOODS DR
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-3262
Mailing Address - Country:US
Mailing Address - Phone:321-636-3066
Mailing Address - Fax:321-636-2545
Practice Address - Street 1:1755 W HIBISCUS BLVD
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-2616
Practice Address - Country:US
Practice Address - Phone:321-724-5437
Practice Address - Fax:321-724-5570
Is Sole Proprietor?:No
Enumeration Date:2012-06-28
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9284414363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL006596000Medicaid