Provider Demographics
NPI:1740562263
Name:ALLISON, MISHEIKA YANIQUE
Entity type:Individual
Prefix:
First Name:MISHEIKA
Middle Name:YANIQUE
Last Name:ALLISON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 N COURTHOUSE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23236-4064
Mailing Address - Country:US
Mailing Address - Phone:804-578-5114
Mailing Address - Fax:
Practice Address - Street 1:611 N COURTHOUSE RD STE 200J
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23236-4064
Practice Address - Country:US
Practice Address - Phone:804-578-5114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-10
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001300798163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse