Provider Demographics
NPI:1700198132
Name:KAPIOTIS, ALYCIA MARIE (CRNP)
Entity Type:Individual
Prefix:
First Name:ALYCIA
Middle Name:MARIE
Last Name:KAPIOTIS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26920 POLLARD RD APT 818
Mailing Address - Street 2:
Mailing Address - City:DAPHNE
Mailing Address - State:AL
Mailing Address - Zip Code:36526-5150
Mailing Address - Country:US
Mailing Address - Phone:251-367-5454
Mailing Address - Fax:
Practice Address - Street 1:7293 ROSCOE RD
Practice Address - Street 2:
Practice Address - City:GULF SHORES
Practice Address - State:AL
Practice Address - Zip Code:36542
Practice Address - Country:US
Practice Address - Phone:251-923-2135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-14
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9324874363LF0000X
AL1-106245363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL011846OtherMEDICARE GROUP NUMBER
AL631300001Medicaid
FL692990700Medicaid