Provider Demographics
NPI:1588316897
Name:ALLISON, MEGAN NICOLE (RN)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:NICOLE
Last Name:ALLISON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1070 HECKLE BLVD STE 307
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-2985
Mailing Address - Country:US
Mailing Address - Phone:803-209-4546
Mailing Address - Fax:
Practice Address - Street 1:1070 HECKLE BLVD STE 307
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-2985
Practice Address - Country:US
Practice Address - Phone:803-209-4546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-19
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC249980163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse