Provider Demographics
NPI:1407636566
Name:VEGA, ALANA ALESSE (APRN)
Entity Type:Individual
Prefix:
First Name:ALANA
Middle Name:ALESSE
Last Name:VEGA
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 1:380 MAIN ST UNIT 40
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-6228
Mailing Address - Country:US
Mailing Address - Phone:203-668-0988
Mailing Address - Fax:
Practice Address - Street 1:540 SAYBROOK RD STE A&100B
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-4711
Practice Address - Country:US
Practice Address - Phone:860-358-2850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-04
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT12485363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily