Provider Demographics
NPI:1962271437
Name:SPRUILL, ALYSSA JOYCE (CRNP)
Entity type:Individual
Prefix:MRS
First Name:ALYSSA
Middle Name:JOYCE
Last Name:SPRUILL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MS
Other - First Name:ALYSSA
Other - Middle Name:JOYCE
Other - Last Name:WYATT/HATHCOCK/BREWER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17065 N HAGLER RD
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:AL
Mailing Address - Zip Code:35475-5034
Mailing Address - Country:US
Mailing Address - Phone:205-475-0516
Mailing Address - Fax:
Practice Address - Street 1:4108 WATERMELON RD
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:AL
Practice Address - Zip Code:35473-5130
Practice Address - Country:US
Practice Address - Phone:205-366-9898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-26
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-155277363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily