Healthcare Provider Details

I. General information

NPI: 1134597305
Provider Name (Legal Business Name): ALYSSA M MEIGHAN CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALYSSA M KOZIK CRNP

II. Dates (important events)

Enumeration Date: 09/04/2015
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 E 2ND ST FL 2
ERIE PA
16507-1579
US

IV. Provider business mailing address

120 E 2ND ST FL 2
ERIE PA
16507-1579
US

V. Phone/Fax

Practice location:
  • Phone: 814-456-8980
  • Fax: 814-451-0443
Mailing address:
  • Phone: 814-456-8980
  • Fax: 814-451-0443

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP015320
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP015320
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN595791
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: