Provider Demographics
NPI:1619602836
Name:WHEELER, ALYSSA BROOKE (PA-C)
Entity Type:Individual
Prefix:MISS
First Name:ALYSSA
Middle Name:BROOKE
Last Name:WHEELER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:442 HURDLETOWN RD
Mailing Address - Street 2:
Mailing Address - City:HERTFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27944-8894
Mailing Address - Country:US
Mailing Address - Phone:252-562-2785
Mailing Address - Fax:
Practice Address - Street 1:442 HURDLETOWN RD
Practice Address - Street 2:
Practice Address - City:HERTFORD
Practice Address - State:NC
Practice Address - Zip Code:27944-8894
Practice Address - Country:US
Practice Address - Phone:252-562-2785
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-21
Last Update Date:2023-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant