Provider Demographics
NPI:1497031538
Name:UKER, ALYSSA L (ARNP)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:L
Last Name:UKER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:L
Other - Last Name:JETER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2535 MAPLECREST RD STE 12
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-2799
Mailing Address - Country:US
Mailing Address - Phone:563-421-3555
Mailing Address - Fax:563-421-3530
Practice Address - Street 1:2140 53RD AVE
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-6279
Practice Address - Country:US
Practice Address - Phone:563-213-5555
Practice Address - Fax:563-421-3530
Is Sole Proprietor?:No
Enumeration Date:2011-11-02
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA115096363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily