Provider Demographics
NPI:1770052425
Name:CLAUSSEN, ALYSSA RAE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ALYSSA
Middle Name:RAE
Last Name:CLAUSSEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1230 N WEBB RD
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-3304
Mailing Address - Country:US
Mailing Address - Phone:308-384-2626
Mailing Address - Fax:
Practice Address - Street 1:1230 N WEBB RD
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-3304
Practice Address - Country:US
Practice Address - Phone:308-384-2626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-23
Last Update Date:2018-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE15844183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist