Provider Demographics
NPI:1538643671
Name:DYETT, ALYSSIA (PHARMD)
Entity Type:Individual
Prefix:
First Name:ALYSSIA
Middle Name:
Last Name:DYETT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4600 UNIVERSITY DR APT 1614
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-6123
Mailing Address - Country:US
Mailing Address - Phone:443-799-5622
Mailing Address - Fax:
Practice Address - Street 1:1106 ENVIRON WAY
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-4418
Practice Address - Country:US
Practice Address - Phone:919-942-8738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-24
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC28313183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist