Provider Demographics
NPI:1164081642
Name:DUNCAN, ALISA MELANIE (APRN)
Entity Type:Individual
Prefix:MS
First Name:ALISA
Middle Name:MELANIE
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2666 LAKEVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKY RIVER
Mailing Address - State:OH
Mailing Address - Zip Code:44116-2562
Mailing Address - Country:US
Mailing Address - Phone:440-570-4264
Mailing Address - Fax:
Practice Address - Street 1:2666 LAKEVIEW AVE
Practice Address - Street 2:
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-2562
Practice Address - Country:US
Practice Address - Phone:440-570-4264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-10
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHF05190277363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily