Provider Demographics
NPI:1427788421
Name:LEFROCK, ALYSSA N (FNP-C)
Entity type:Individual
Prefix:MS
First Name:ALYSSA
Middle Name:N
Last Name:LEFROCK
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8820 E SAN RAFAEL DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-1929
Mailing Address - Country:US
Mailing Address - Phone:480-226-3674
Mailing Address - Fax:
Practice Address - Street 1:8820 E SAN RAFAEL DR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-1929
Practice Address - Country:US
Practice Address - Phone:480-226-3674
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRNP276256363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily