Provider Demographics
NPI:1891801916
Name:PAISLEY, ALISA ANNE (FNP)
Entity Type:Individual
Prefix:
First Name:ALISA
Middle Name:ANNE
Last Name:PAISLEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 E 54TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807-2797
Mailing Address - Country:US
Mailing Address - Phone:563-355-9990
Mailing Address - Fax:563-355-9999
Practice Address - Street 1:1820 E 54TH ST STE B
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-2797
Practice Address - Country:US
Practice Address - Phone:563-355-9990
Practice Address - Fax:563-355-9999
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA100558207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine