Healthcare Provider Details

I. General information

NPI: 1972296655
Provider Name (Legal Business Name): ALYSA MARKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2023
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1048 HIGHLAND RIDGE DR
MANHATTAN KS
66503-8004
US

IV. Provider business mailing address

1048 HIGHLAND RIDGE DR
MANHATTAN KS
66503-8004
US

V. Phone/Fax

Practice location:
  • Phone: 620-664-8451
  • Fax:
Mailing address:
  • Phone: 785-577-2341
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number24-01865
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: