Basic Information
Provider Information
NPI: 1003266990
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CLAUNCH
FirstName: ALISON
MiddleName: R
NamePrefix:  
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 1080
Address2:  
City: BURKESVILLE
State: KY
PostalCode: 427171080
CountryCode: US
TelephoneNumber: 2708586655
FaxNumber: 2708584027
Practice Location
Address1: 197 WILL WALKER RD
Address2:  
City: COLUMBIA
State: KY
PostalCode: 427287436
CountryCode: US
TelephoneNumber: 2703849981
FaxNumber: 2703849981
Other Information
ProviderEnumerationDate: 06/21/2016
LastUpdateDate: 06/17/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/17/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X3010387KYY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

ID Information
IDTypeStateIssuerDescription
301038701KYSTATE LICENSEOTHER
710042351005KY MEDICAID


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