Provider Demographics
NPI:1295905883
Name:DUFFY, ALESIA C (RN)
Entity type:Individual
Prefix:MRS
First Name:ALESIA
Middle Name:C
Last Name:DUFFY
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 1:4410 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72116-8154
Mailing Address - Country:US
Mailing Address - Phone:501-940-7557
Mailing Address - Fax:
Practice Address - Street 1:4410 RIDGE RD
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72116-8154
Practice Address - Country:US
Practice Address - Phone:501-940-7557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-10
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR42132163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse