Provider Demographics
NPI:1588270987
Name:BEAR, ALYSSA (CRNA)
Entity type:Individual
Prefix:MS
First Name:ALYSSA
Middle Name:
Last Name:BEAR
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:
Other - Last Name:HENSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5215 TACOA CIR
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37411-5332
Mailing Address - Country:US
Mailing Address - Phone:423-661-0018
Mailing Address - Fax:
Practice Address - Street 1:2525 DE SALES AVENUE
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404
Practice Address - Country:US
Practice Address - Phone:423-495-2525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-21
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN189432163W00000X
TN28349367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse