Provider Demographics
NPI:1891574851
Name:BRANSTON, ALLYSON JAIME (FNP-C)
Entity type:Individual
Prefix:
First Name:ALLYSON
Middle Name:JAIME
Last Name:BRANSTON
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15255 N 40TH ST STE 127
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-4638
Mailing Address - Country:US
Mailing Address - Phone:602-694-3566
Mailing Address - Fax:602-391-2576
Practice Address - Street 1:15255 N 40TH ST STE 127
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-4638
Practice Address - Country:US
Practice Address - Phone:602-694-3566
Practice Address - Fax:602-391-2576
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ296021363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily