Provider Demographics
NPI:1396208054
Name:HAMIK, ALYSSA K (PA-C)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:K
Last Name:HAMIK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:K
Other - Last Name:BLUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:809 ELM ST
Mailing Address - Street 2:
Mailing Address - City:MISSOURI VALLEY
Mailing Address - State:IA
Mailing Address - Zip Code:51555-1140
Mailing Address - Country:US
Mailing Address - Phone:712-642-2794
Mailing Address - Fax:712-642-9338
Practice Address - Street 1:809 ELM ST
Practice Address - Street 2:
Practice Address - City:MISSOURI VALLEY
Practice Address - State:IA
Practice Address - Zip Code:51555-1140
Practice Address - Country:US
Practice Address - Phone:712-642-2794
Practice Address - Fax:712-642-9338
Is Sole Proprietor?:No
Enumeration Date:2019-04-10
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA095329363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant