Healthcare Provider Details

I. General information

NPI: 1083156160
Provider Name (Legal Business Name): ALYSSA J VALENTE CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2016
Last Update Date: 06/01/2022
Certification Date: 06/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 S CEDAR CREST BLVD
ALLENTOWN PA
18103-6202
US

IV. Provider business mailing address

PO BOX 8500 LOCKBOX 3367
PHILADELPHIA PA
19178-3367
US

V. Phone/Fax

Practice location:
  • Phone: 610-402-8001
  • Fax: 610-402-8240
Mailing address:
  • Phone: 517-787-6440
  • Fax: 517-787-4146

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN659342
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAP133220
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: