Provider Demographics
NPI:1750678181
Name:MCCUTCHEN, ALLISON DENNISON (APRN)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:DENNISON
Last Name:MCCUTCHEN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:12201 BLUEGRASS PKWY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-2361
Mailing Address - Country:US
Mailing Address - Phone:502-568-7364
Mailing Address - Fax:502-568-7136
Practice Address - Street 1:599 ROGERSVILLE RD
Practice Address - Street 2:
Practice Address - City:RADCLIFF
Practice Address - State:KY
Practice Address - Zip Code:40160-9321
Practice Address - Country:US
Practice Address - Phone:270-351-2999
Practice Address - Fax:270-351-3994
Is Sole Proprietor?:No
Enumeration Date:2011-07-06
Last Update Date:2019-06-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN71005595A363LF0000X
KY3006994363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100180550Medicaid