Provider Demographics
NPI:1760022875
Name:NICHOLAS, ALYSSA BRAY (DNP, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:BRAY
Last Name:NICHOLAS
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-C
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:MORGAN
Other - Last Name:BRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 11407 DEPT # 8094
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35246-0100
Mailing Address - Country:US
Mailing Address - Phone:251-410-4001
Mailing Address - Fax:
Practice Address - Street 1:3715 DAUPHIN ST STE 7A
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-1775
Practice Address - Country:US
Practice Address - Phone:251-410-4001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-07
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-150961363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily