Provider Demographics
NPI:1992170476
Name:ALDERIN, ALISON H (FNP)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:H
Last Name:ALDERIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:H
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:808 BEACON ST
Mailing Address - Street 2:
Mailing Address - City:WAYCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:31501-7104
Mailing Address - Country:US
Mailing Address - Phone:912-490-4325
Mailing Address - Fax:912-490-2873
Practice Address - Street 1:808 BEACON ST
Practice Address - Street 2:
Practice Address - City:WAYCROSS
Practice Address - State:GA
Practice Address - Zip Code:31501
Practice Address - Country:US
Practice Address - Phone:912-490-4325
Practice Address - Fax:912-490-2873
Is Sole Proprietor?:No
Enumeration Date:2015-12-09
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN145021363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily