Provider Demographics
NPI:1700166139
Name:WISLANDER, ALYSSA N (ARNP)
Entity Type:Individual
Prefix:DR
First Name:ALYSSA
Middle Name:N
Last Name:WISLANDER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2906 W CENTRAL PARK AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52804-2674
Mailing Address - Country:US
Mailing Address - Phone:563-386-8200
Mailing Address - Fax:563-391-1936
Practice Address - Street 1:2906 W CENTRAL PARK AVE STE 1
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52804-2674
Practice Address - Country:US
Practice Address - Phone:563-386-8200
Practice Address - Fax:563-391-1936
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-17
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAC178274363LP0200X
IAL109037363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics