Dolla Jean Allison, CNS, NNP

Individual provider Active NPI Critical Care Neonatal Nurse Practitioner · Orem, UT

NPI 1609050608 · NPPES record last updated Aug 26, 2014

Key facts

NPI
1609050608
Entity type
Individual (NPI type 1)
Primary specialty
Critical Care Neonatal Nurse Practitioner 363LN0005X
License
5557181-4405 (UT)
Practice address
730 W 800 N
Suite 340B
Orem, UT 84057-6318
Phone
(801) 655-5425
Fax
(801) 655-5426
NPI assigned
Dec 26, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Certified Nurse Specialist

State licenses

LicenseStateTypeSpecialty
NNP 689AIDMDNeonatal Nurse Practitioner
5557181-4405UTMDCritical Care Neonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wasatch Neonatal LC Neonatal, Critical Care Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Neonatal Nurse Practitioner 363LN0005X 5557181-4405 UT Yes
Neonatal Nurse Practitioner 363LN0000X NNP 689A ID

Addresses

Primary practice location

730 W 800 N
Suite 340B
Orem, UT 84057-6318

Mailing address

730 W 800 N
Suite 340B
Orem, UT 84057-6318
Phone (801) 655-5425

Other providers in Orem, UT

All providers in Orem, UT · Critical Care Neonatal Nurse Practitioner in Utah

Sources for this page

Verify at the official NPI Registry.