Provider Demographics
NPI:1598359077
Name:LOUGHREN, ALYSIA KAY (FNP)
Entity Type:Individual
Prefix:
First Name:ALYSIA
Middle Name:KAY
Last Name:LOUGHREN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2904 LONDON BELL DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27614-7530
Mailing Address - Country:US
Mailing Address - Phone:919-971-1441
Mailing Address - Fax:
Practice Address - Street 1:13200 FALLS OF NEUSE RD STE 113
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27614-8269
Practice Address - Country:US
Practice Address - Phone:919-971-1411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-24
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC5014131363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care