Provider Demographics
NPI:1851161855
Name:GARRETT, ALLISON (NP)
Entity type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:
Last Name:GARRETT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 LEXINGTON DR STE A
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-6986
Mailing Address - Country:US
Mailing Address - Phone:601-707-3771
Mailing Address - Fax:601-707-3751
Practice Address - Street 1:101 LEXINGTON DR STE A
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:MS
Practice Address - Zip Code:39110-6986
Practice Address - Country:US
Practice Address - Phone:601-707-3771
Practice Address - Fax:601-707-3751
Is Sole Proprietor?:No
Enumeration Date:2024-01-02
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS905837363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics