Provider Demographics
NPI:1629827209
Name:THURBER, ALYSSA (NP)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:THURBER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2995 DREW ST FL 2
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33759-3012
Mailing Address - Country:US
Mailing Address - Phone:727-281-9065
Mailing Address - Fax:
Practice Address - Street 1:8787 BRYAN DAIRY RD STE 275
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33777-1260
Practice Address - Country:US
Practice Address - Phone:727-394-5650
Practice Address - Fax:727-635-7939
Is Sole Proprietor?:No
Enumeration Date:2024-05-15
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11032826363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily