Provider Demographics
NPI:1891518171
Name:SPILLER, ALYSON LYNN (CNP)
Entity type:Individual
Prefix:
First Name:ALYSON
Middle Name:LYNN
Last Name:SPILLER
Suffix:
Gender:
Credentials:CNP
Other - Prefix:
Other - First Name:ALYSON
Other - Middle Name:LYNN
Other - Last Name:SPEARS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1479 CAMERON DR
Mailing Address - Street 2:
Mailing Address - City:FAIRBORN
Mailing Address - State:OH
Mailing Address - Zip Code:45324-8547
Mailing Address - Country:US
Mailing Address - Phone:937-478-9219
Mailing Address - Fax:
Practice Address - Street 1:2141 N FAIRFIELD RD STE 125
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45431-2578
Practice Address - Country:US
Practice Address - Phone:937-458-0085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-05
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0037331363LG0600X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology