Provider Demographics
NPI:1902271349
Name:STILLWELL, ALISON LEIGH (FNP-BC)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:LEIGH
Last Name:STILLWELL
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:
Other - Last Name:BOUSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:755 W CARMEL DR STE 150
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-5878
Mailing Address - Country:US
Mailing Address - Phone:317-810-1399
Mailing Address - Fax:317-810-1391
Practice Address - Street 1:755 W CARMEL DR STE 150
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-5878
Practice Address - Country:US
Practice Address - Phone:317-810-1399
Practice Address - Fax:317-810-1391
Is Sole Proprietor?:No
Enumeration Date:2015-12-10
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60608127363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner