Provider Demographics
NPI:1982343778
Name:HARL, ALYSSA MARIE (PA-C)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:MARIE
Last Name:HARL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2810 JAMESON N APT 3
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-4970
Mailing Address - Country:US
Mailing Address - Phone:952-484-1969
Mailing Address - Fax:
Practice Address - Street 1:1240 ARIES DR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68512-9100
Practice Address - Country:US
Practice Address - Phone:402-420-1300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-01
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant