Provider Demographics
NPI:1427510254
Name:ALANTHO, ALISA RENEE
Entity type:Individual
Prefix:
First Name:ALISA
Middle Name:RENEE
Last Name:ALANTHO
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 1:1025 PEERLESS XING NW
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37312-3764
Mailing Address - Country:US
Mailing Address - Phone:423-476-5990
Mailing Address - Fax:423-476-5887
Practice Address - Street 1:7564 CHAPMAN HWY
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-6684
Practice Address - Country:US
Practice Address - Phone:423-476-5990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-01
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant