Provider Demographics
NPI:1689244212
Name:BROWN, ALYSSA (RN, BSN)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 LOBLOLLY LN
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:AL
Mailing Address - Zip Code:35504-7405
Mailing Address - Country:US
Mailing Address - Phone:205-522-2787
Mailing Address - Fax:
Practice Address - Street 1:411 LOBLOLLY LN
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35504-7405
Practice Address - Country:US
Practice Address - Phone:205-522-2787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-27
Last Update Date:2021-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program