Provider Demographics
NPI:1427516053
Name:HELD, ALYSA PATRICIA (AGACNP)
Entity type:Individual
Prefix:DR
First Name:ALYSA
Middle Name:PATRICIA
Last Name:HELD
Suffix:
Gender:F
Credentials:AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3821 S WALAPAI DR
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86005-6608
Mailing Address - Country:US
Mailing Address - Phone:928-853-5473
Mailing Address - Fax:
Practice Address - Street 1:1200 N BEAVER ST
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-3118
Practice Address - Country:US
Practice Address - Phone:928-799-3366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-02
Last Update Date:2020-09-10
Deactivation Date:2019-03-05
Deactivation Code:
Reactivation Date:2019-03-12
Provider Licenses
StateLicense IDTaxonomies
AZ223109363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care