Provider Demographics
NPI:1548676810
Name:LAGRANGE, ALISON (ARNP)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:LAGRANGE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 N 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:VINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52349-2254
Mailing Address - Country:US
Mailing Address - Phone:319-472-6300
Mailing Address - Fax:319-472-2524
Practice Address - Street 1:504 N 9TH AVE
Practice Address - Street 2:
Practice Address - City:VINTON
Practice Address - State:IA
Practice Address - Zip Code:52349-2254
Practice Address - Country:US
Practice Address - Phone:319-472-6300
Practice Address - Fax:319-472-2524
Is Sole Proprietor?:No
Enumeration Date:2014-07-08
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA122525363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner