Provider Demographics
NPI:1053109439
Name:BARDILL, ALLISON NICOLE (APRN, CPNP-CP)
Entity type:Individual
Prefix:MS
First Name:ALLISON
Middle Name:NICOLE
Last Name:BARDILL
Suffix:
Gender:
Credentials:APRN, CPNP-CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 SE 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33060-8052
Mailing Address - Country:US
Mailing Address - Phone:954-850-5533
Mailing Address - Fax:
Practice Address - Street 1:470 SE 8TH AVE
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33060-8052
Practice Address - Country:US
Practice Address - Phone:954-850-5533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC309833163W00000X
FLAPRN11015957363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse