Provider Demographics
NPI:1255646113
Name:YANCEY, ALISSA N (RN)
Entity type:Individual
Prefix:MS
First Name:ALISSA
Middle Name:N
Last Name:YANCEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1074 S DAHLIA ST APT G533
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CO
Mailing Address - Zip Code:80246-4254
Mailing Address - Country:US
Mailing Address - Phone:315-222-6676
Mailing Address - Fax:
Practice Address - Street 1:1074 S DAHLIA ST APT G533
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CO
Practice Address - Zip Code:80246-4254
Practice Address - Country:US
Practice Address - Phone:315-222-6676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-16
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC228348163WP0808X
NY605187163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health