Provider Demographics
NPI:1730922006
Name:WRISTON, ALLISON BROOKE (APRN-CNP)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:BROOKE
Last Name:WRISTON
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:882 FOLA RD
Mailing Address - Street 2:
Mailing Address - City:BICKMORE
Mailing Address - State:WV
Mailing Address - Zip Code:25019-9762
Mailing Address - Country:US
Mailing Address - Phone:681-319-8909
Mailing Address - Fax:
Practice Address - Street 1:400 FAIRVIEW HEIGHTS RD
Practice Address - Street 2:
Practice Address - City:SUMMERSVILLE
Practice Address - State:WV
Practice Address - Zip Code:26651-9308
Practice Address - Country:US
Practice Address - Phone:304-872-2891
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-14
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV120177363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily