Provider Demographics
NPI:1154187078
Name:BLOW, ALYSA
Entity type:Individual
Prefix:
First Name:ALYSA
Middle Name:
Last Name:BLOW
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 1:308 N 39TH ST E
Mailing Address - Street 2:
Mailing Address - City:ELY
Mailing Address - State:NV
Mailing Address - Zip Code:89301-6653
Mailing Address - Country:US
Mailing Address - Phone:775-301-7314
Mailing Address - Fax:
Practice Address - Street 1:308 N 39TH ST E
Practice Address - Street 2:
Practice Address - City:ELY
Practice Address - State:NV
Practice Address - Zip Code:89301-6653
Practice Address - Country:US
Practice Address - Phone:775-301-7314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide