Provider Demographics
NPI:1386133510
Name:DUGAS, ALYSSA LYNN (APRN)
Entity type:Individual
Prefix:MRS
First Name:ALYSSA
Middle Name:LYNN
Last Name:DUGAS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 VICKI LN
Mailing Address - Street 2:
Mailing Address - City:COLCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06415-1041
Mailing Address - Country:US
Mailing Address - Phone:203-640-5203
Mailing Address - Fax:
Practice Address - Street 1:1050 SULLIVAN AVE STE A4
Practice Address - Street 2:
Practice Address - City:SOUTH WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06074-2000
Practice Address - Country:US
Practice Address - Phone:860-648-2748
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-03
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT7544363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health