Provider Demographics
NPI:1508573551
Name:BRETZ, ALYSSA SHEDLOCK (PA-C)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:SHEDLOCK
Last Name:BRETZ
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:
Other - Last Name:SHEDLOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2 JENNIFER CT STE B
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17015-7694
Mailing Address - Country:US
Mailing Address - Phone:717-218-9830
Mailing Address - Fax:
Practice Address - Street 1:2 JENNIFER CT STE B
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17015-7694
Practice Address - Country:US
Practice Address - Phone:717-218-9830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-31
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant