Provider Demographics
NPI:1629438155
Name:BARR, ALYSSA (RN)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:BARR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:
Other - Last Name:SNYDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:8091 TOWNSHIP LINE RD STE 206
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-2495
Mailing Address - Country:US
Mailing Address - Phone:317-415-1000
Mailing Address - Fax:317-415-1010
Practice Address - Street 1:8091 TOWNSHIP LINE RD STE 206
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-2495
Practice Address - Country:US
Practice Address - Phone:317-415-1000
Practice Address - Fax:317-415-1010
Is Sole Proprietor?:No
Enumeration Date:2016-02-25
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28164399A163W00000X
IN71006313A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201364770Medicaid