Provider Demographics
NPI:1699343400
Name:SMOLEN, ALYSSA MARIE (DNP, APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:MARIE
Last Name:SMOLEN
Suffix:
Gender:
Credentials:DNP, APRN, FNP-BC
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:MARIE
Other - Last Name:WILLENBRING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8600 IL-91
Mailing Address - Street 2:SUITE 400
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61615
Mailing Address - Country:US
Mailing Address - Phone:309-683-4300
Mailing Address - Fax:
Practice Address - Street 1:8600 IL-91
Practice Address - Street 2:SUITE 400
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61615
Practice Address - Country:US
Practice Address - Phone:309-683-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-16
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.023372363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily