Provider Demographics
NPI:1336823996
Name:LEMPKA, ALYSSA (FNP-C)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:LEMPKA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:
Other - Last Name:PROSCENO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1424 PULLIAM AVE
Mailing Address - Street 2:
Mailing Address - City:WORLAND
Mailing Address - State:WY
Mailing Address - Zip Code:82401-2824
Mailing Address - Country:US
Mailing Address - Phone:307-250-4862
Mailing Address - Fax:
Practice Address - Street 1:808 COFFEEN AVE
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801-5318
Practice Address - Country:US
Practice Address - Phone:307-763-8701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-14
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY41139163W00000X
WY53212363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY1679043756Medicaid