Provider Demographics
NPI:1225922511
Name:SPARHAWK, ALYSSA JANE (PMHNP)
Entity type:Individual
Prefix:MISS
First Name:ALYSSA
Middle Name:JANE
Last Name:SPARHAWK
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 SW 47TH AVE
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-4823
Mailing Address - Country:US
Mailing Address - Phone:865-712-4777
Mailing Address - Fax:
Practice Address - Street 1:1110 SW 47TH AVE
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-4823
Practice Address - Country:US
Practice Address - Phone:865-712-4777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-03
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2025024748363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health