Provider Demographics
NPI:1215478797
Name:FINKE, ALYSSA O'NEIL
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:O'NEIL
Last Name:FINKE
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 1:160 FAIRWAY DR
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-3149
Mailing Address - Country:US
Mailing Address - Phone:507-469-9368
Mailing Address - Fax:
Practice Address - Street 1:160 FAIRWAY DR
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-3149
Practice Address - Country:US
Practice Address - Phone:507-469-9368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-16
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer