Provider Demographics
NPI:1588394134
Name:SMITH, ALISON (RN)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:SMITH
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 1:4620 REKA DR APT B15
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-3617
Mailing Address - Country:US
Mailing Address - Phone:808-443-3005
Mailing Address - Fax:
Practice Address - Street 1:1840 BRAGAW ST STE 110
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-3463
Practice Address - Country:US
Practice Address - Phone:907-562-4155
Practice Address - Fax:907-563-2891
Is Sole Proprietor?:No
Enumeration Date:2022-06-15
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1675300163W00000X
AK181583163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse