Dearth, Alyssa Ann
Dearth, Alyssa Ann is an individual health care provider with primary practice located at 151 W High St Lowr Level , Morris IL 60450-1407. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Dearth, Alyssa Ann can be contacted via phone (815) 705-1000.Contact Information
Primary practice address
151 W High St Lowr Level
Morris IL 60450-1407
Phone: (815) 705-1000
Fax: (815) 705-2709
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 209010633 | Illinois |
Profile Details
| NPI number | 1376976365 |
|---|---|
| LBN Legal business name | Dearth, Alyssa Ann |
| Credentials | MSN, APN, FNP-BC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 14th, 2013 |
| Last updated | Jan 20th, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1376976365 | NPPES |
| Illinois | Other | 206147 | MEDICARE (GROUP PTAN) |
| Illinois | Other | F400099927 | MEDICARE (GROUP PTAN) |
| Illinois | Other | 209.010633 | MEDICARE (GROUP PTAN) |
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