Provider Demographics
NPI:1487179818
Name:JOSEPH, ALLISSA KAY (APRN)
Entity type:Individual
Prefix:
First Name:ALLISSA
Middle Name:KAY
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 6TH AVE BLDG B
Mailing Address - Street 2:
Mailing Address - City:KINDER
Mailing Address - State:LA
Mailing Address - Zip Code:70648-3187
Mailing Address - Country:US
Mailing Address - Phone:337-738-9494
Mailing Address - Fax:337-738-9449
Practice Address - Street 1:108 6TH AVE BLDG B
Practice Address - Street 2:
Practice Address - City:KINDER
Practice Address - State:LA
Practice Address - Zip Code:70648-3187
Practice Address - Country:US
Practice Address - Phone:337-738-9494
Practice Address - Fax:337-738-9449
Is Sole Proprietor?:No
Enumeration Date:2017-08-07
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT7119363LF0000X
LA219554363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily