Provider Demographics
NPI:1386934131
Name:PULS, ALISSA LOUISE (RN BSN)
Entity type:Individual
Prefix:MISS
First Name:ALISSA
Middle Name:LOUISE
Last Name:PULS
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3054 TANNER RD
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55129-5208
Mailing Address - Country:US
Mailing Address - Phone:651-331-8630
Mailing Address - Fax:
Practice Address - Street 1:3054 TANNER RD
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55129-5208
Practice Address - Country:US
Practice Address - Phone:651-331-8630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-13
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI174530-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse