Provagna, Alyssa J

Provagna, Alyssa J is an sole proprietor health care provider with primary practice located at 4430 Missouri Ave , Fort Leonard Wood MO 65473-9098. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / General Practice, Allopathic & Osteopathic Physicians / Obstetrics & Gynecology. Allopathic & Osteopathic Physicians / Obstetrics & Gynecology is her primary health care specialty. Provagna, Alyssa J can be contacted via phone (573) 596-1770.

Contact Information

Primary practice address
4430 Missouri Ave Fort Leonard Wood MO 65473-9098
Phone: (573) 596-1770
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X 010127064 Virginia
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 0101270674 Virginia

Profile Details

NPI number 1578024527
LBN Legal business name Provagna, Alyssa J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 30th, 2019
Last updated Jul 28th, 2023 - about 3 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.

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