Provider Demographics
NPI:1316752421
Name:MOORE, ALYSSA (FNP)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:MOORE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:
Other - Last Name:FONTAINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4 VASSAR DR
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-1219
Mailing Address - Country:US
Mailing Address - Phone:774-254-7481
Mailing Address - Fax:
Practice Address - Street 1:4 VASSAR DR
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-1219
Practice Address - Country:US
Practice Address - Phone:774-254-7481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program