Provider Demographics
NPI:1134597305
Name:MEIGHAN, ALYSSA M (CRNP)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:M
Last Name:MEIGHAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:M
Other - Last Name:KOZIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:2315 MYRTLE ST STE 190
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16502-4604
Mailing Address - Country:US
Mailing Address - Phone:814-453-7767
Mailing Address - Fax:814-454-6667
Practice Address - Street 1:2315 MYRTLE ST STE 190
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16502-4604
Practice Address - Country:US
Practice Address - Phone:814-453-7767
Practice Address - Fax:814-454-6667
Is Sole Proprietor?:No
Enumeration Date:2015-09-04
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN595791163W00000X
PASP015320363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner