Provider Demographics
NPI:1396245304
Name:KERN, ALYSSA JANETTE
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:JANETTE
Last Name:KERN
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 1:2023 YALE DR
Mailing Address - Street 2:
Mailing Address - City:LEVELLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79336-6723
Mailing Address - Country:US
Mailing Address - Phone:806-777-1906
Mailing Address - Fax:
Practice Address - Street 1:2023 YALE DR
Practice Address - Street 2:
Practice Address - City:LEVELLAND
Practice Address - State:TX
Practice Address - Zip Code:79336-6723
Practice Address - Country:US
Practice Address - Phone:806-777-1906
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-15
Last Update Date:2018-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX880056163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse