Provider Demographics
NPI:1962010405
Name:VOGEL, ALYSSA (MSN, FNP-C)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:VOGEL
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:
Other - Last Name:HENNIGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN,FNP-C
Mailing Address - Street 1:321 MANLEY ST
Mailing Address - Street 2:
Mailing Address - City:WEST BRIDGEWATER
Mailing Address - State:MA
Mailing Address - Zip Code:02379-1022
Mailing Address - Country:US
Mailing Address - Phone:508-930-8574
Mailing Address - Fax:
Practice Address - Street 1:321 MANLEY ST
Practice Address - Street 2:
Practice Address - City:W BRIDGEWATER
Practice Address - State:MA
Practice Address - Zip Code:02379-1022
Practice Address - Country:US
Practice Address - Phone:781-341-4145
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-21
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2293678363LF0000X, 163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical