Provider Demographics
NPI:1801576632
Name:SMITH, ALYSON O (FNP-C)
Entity type:Individual
Prefix:
First Name:ALYSON
Middle Name:O
Last Name:SMITH
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1965 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801-5403
Mailing Address - Country:US
Mailing Address - Phone:334-705-0012
Mailing Address - Fax:334-705-0378
Practice Address - Street 1:1965 1ST AVE
Practice Address - Street 2:
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-5403
Practice Address - Country:US
Practice Address - Phone:334-364-1366
Practice Address - Fax:334-742-9224
Is Sole Proprietor?:No
Enumeration Date:2023-07-18
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-182173363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily