Provider Demographics
NPI:1356733885
Name:NEWMAN, ALYSSA (NP-C)
Entity type:Individual
Prefix:MS
First Name:ALYSSA
Middle Name:
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:
Other - Last Name:CRIVELLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:777 BANNOCK ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-4597
Mailing Address - Country:US
Mailing Address - Phone:303-602-7260
Mailing Address - Fax:303-602-7263
Practice Address - Street 1:777 BANNOCK ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204
Practice Address - Country:US
Practice Address - Phone:303-602-7260
Practice Address - Fax:303-602-7263
Is Sole Proprietor?:No
Enumeration Date:2015-02-20
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1631061163W00000X
COAPN.0993982-NP363LF0000X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily