Provider Demographics
NPI:1255655874
Name:KILLION, ALYSSA (APN)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:KILLION
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 S CHURCH ST STE 14
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-2936
Mailing Address - Country:US
Mailing Address - Phone:856-372-1819
Mailing Address - Fax:856-872-3643
Practice Address - Street 1:1200 S CHURCH ST STE 14
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-2936
Practice Address - Country:US
Practice Address - Phone:856-372-1819
Practice Address - Fax:856-872-3643
Is Sole Proprietor?:No
Enumeration Date:2010-03-25
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00381100363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health