Provider Demographics
NPI:1427451533
Name:NADEL, ALYSIA (RN, BSN, CPN)
Entity type:Individual
Prefix:MRS
First Name:ALYSIA
Middle Name:
Last Name:NADEL
Suffix:
Gender:F
Credentials:RN, BSN, CPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2315 SW 44TH ST
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-8046
Mailing Address - Country:US
Mailing Address - Phone:253-335-9343
Mailing Address - Fax:
Practice Address - Street 1:2315 SW 44TH ST
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-8046
Practice Address - Country:US
Practice Address - Phone:253-335-9343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-02
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0112339163W00000X
WARN00165800163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse