Provider Demographics
NPI:1346890068
Name:KNAPP, ALYSSA ROSE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:ALYSSA
Middle Name:ROSE
Last Name:KNAPP
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 EL CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85635-5900
Mailing Address - Country:US
Mailing Address - Phone:623-261-2140
Mailing Address - Fax:
Practice Address - Street 1:5750 E HIGHWAY 90 STE 200
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-9113
Practice Address - Country:US
Practice Address - Phone:520-263-3762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-14
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical