Provider Demographics
NPI:1700631041
Name:ZWELLING, ALISSA JANICE (RN)
Entity Type:Individual
Prefix:
First Name:ALISSA
Middle Name:JANICE
Last Name:ZWELLING
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1147 PAYNE AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-2730
Mailing Address - Country:US
Mailing Address - Phone:716-329-7052
Mailing Address - Fax:
Practice Address - Street 1:1147 PAYNE AVE
Practice Address - Street 2:
Practice Address - City:NORTH TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14120-2730
Practice Address - Country:US
Practice Address - Phone:716-329-7052
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-19
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY890938163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics