Provider Demographics
NPI:1316224835
Name:FRIERSON, ALISA KAY (APRN)
Entity Type:Individual
Prefix:MRS
First Name:ALISA
Middle Name:KAY
Last Name:FRIERSON
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 1:4343 E OUTLIER BLVD STE 110W
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85008-6540
Mailing Address - Country:US
Mailing Address - Phone:602-610-2772
Mailing Address - Fax:
Practice Address - Street 1:4343 E OUTLIER BLVD STE 110W
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85008-6540
Practice Address - Country:US
Practice Address - Phone:602-610-2772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-11
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN 218717363LW0102X
AZAP8408363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health