ALYSSA WALL NPI 1972131878

NPI Information

NPI: 1972131878
Provider Name: ALYSSA WALL
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
4075 OLD WESTERN ROW RD
MASON, OH
ZIP 45040
Phone: (513) 536-4673
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Alyssa Wall is a psychiatric/mental health nurse practitioner in Mason, OH with 3 years of experience. Alyssa Wall NPI is 1972131878. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF TENNESSEE, HSC, COLLEGE OF MEDICINE
Graduation Year:2021

The provider's business location address is:

4075 OLD WESTERN ROW RD
MASON, OH
ZIP 45040-104
Phone: (513) 536-4673

The NPI 1972131878 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/28/2020 and was last updated on 10/18/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163WP0808X	Registered Nurse	Psychiatric/Mental Health	219471	TENNESSEE	No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	30113	TENNESSEE	No
3	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	0031874	OHIO	Yes
4	163W00000X	Registered Nurse		511767	OHIO	No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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