Provider Demographics
NPI:1538543145
Name:WEBB, ALYSSA
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:WEBB
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:191 CARRAWAY DR STE A
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:AL
Mailing Address - Zip Code:35594-5074
Mailing Address - Country:US
Mailing Address - Phone:205-487-1586
Mailing Address - Fax:205-487-1589
Practice Address - Street 1:191 CARRAWAY DR
Practice Address - Street 2:SUITE A
Practice Address - City:WINFIELD
Practice Address - State:AL
Practice Address - Zip Code:35594-5067
Practice Address - Country:US
Practice Address - Phone:205-487-1586
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-13
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-136697363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily