Provider Demographics
NPI:1093433542
Name:FRISBY, ALYSSA M (MS, RD, LD)
Entity Type:Individual
Prefix:MRS
First Name:ALYSSA
Middle Name:M
Last Name:FRISBY
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15036 HIGHWAY 89 S
Mailing Address - Street 2:
Mailing Address - City:LONOKE
Mailing Address - State:AR
Mailing Address - Zip Code:72086-8508
Mailing Address - Country:US
Mailing Address - Phone:828-335-2307
Mailing Address - Fax:
Practice Address - Street 1:15036 HIGHWAY 89 S
Practice Address - Street 2:
Practice Address - City:LONOKE
Practice Address - State:AR
Practice Address - Zip Code:72086-8508
Practice Address - Country:US
Practice Address - Phone:828-335-2307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-19
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2143133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered