Provider Demographics
NPI:1730785189
Name:TASKIN, ALLISON ROSE (AGACNP-BC)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:ROSE
Last Name:TASKIN
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 PINE GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:RI
Mailing Address - Zip Code:02865-3615
Mailing Address - Country:US
Mailing Address - Phone:401-474-7724
Mailing Address - Fax:
Practice Address - Street 1:16 PINE GROVE AVE
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:RI
Practice Address - Zip Code:02865-3615
Practice Address - Country:US
Practice Address - Phone:401-474-7724
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-10
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN02517363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care