ALYSSA ROSE DOHERTY NP NPI 1528867132

NPI Information

  • NPI: 1528867132
  • Provider Name: ALYSSA ROSE DOHERTY, NP
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 2845 GREENBRIER RD
    GREEN BAY, WI
    ZIP 54311
  • Phone: (920) 288-8000

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NPI Details

Alyssa Rose Doherty, NP is a family nurse practitioner in Green Bay, WI with 2 years of experience. Alyssa Rose Doherty, NP NPI is 1528867132. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2845 GREENBRIER RD
GREEN BAY, WI
ZIP 54311-519
Phone: (920) 288-8000

The NPI 1528867132 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 3/8/2025 and was last updated on 8/28/2025.

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
1363L00000XNurse Practitioner15770-33WISCONSINNo
2363LF0000XNurse PractitionerFamily15770-33WISCONSINYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1100317174MEDICAIDWISCONSIN

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: 11/21/2025

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