Provider Demographics
NPI:1710130802
Name:SAPP, ALYSSA B (APRN, FNP)
Entity Type:Individual
Prefix:MRS
First Name:ALYSSA
Middle Name:B
Last Name:SAPP
Suffix:
Gender:F
Credentials:APRN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 BERRYWOOD DRIVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201
Mailing Address - Country:US
Mailing Address - Phone:573-815-0662
Mailing Address - Fax:573-443-1162
Practice Address - Street 1:3401 BERRYWOOD DRIVE
Practice Address - Street 2:SUITE 201
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201
Practice Address - Country:US
Practice Address - Phone:573-815-0662
Practice Address - Fax:573-443-1162
Is Sole Proprietor?:No
Enumeration Date:2008-11-03
Last Update Date:2010-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MORN126673363LF0000X
MO126673363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily