Provider Demographics
NPI:1538841598
Name:ORTEGON, ALYSSA JO (MSN, APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:JO
Last Name:ORTEGON
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 E SAVANNAH AVE BLDG C101
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1242
Mailing Address - Country:US
Mailing Address - Phone:956-686-2626
Mailing Address - Fax:956-686-1616
Practice Address - Street 1:110 E SAVANNAH AVE STE 101
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1241
Practice Address - Country:US
Practice Address - Phone:956-686-2626
Practice Address - Fax:956-686-1616
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-01
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX806402163WP0200X, 163WC0400X
TX1130832363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No163WP0200XNursing Service ProvidersRegistered NursePediatricsGroup - Single Specialty
No163WC0400XNursing Service ProvidersRegistered NurseCase Management