Healthcare Provider Details

I. General information

NPI: 1992090104
Provider Name (Legal Business Name): ALYSHA A. STOKES FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALYSHA A. THOMPSON

II. Dates (important events)

Enumeration Date: 06/15/2011
Last Update Date: 06/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W 1400 S
GARLAND UT
84312-9100
US

IV. Provider business mailing address

300 W 1400 S
GARLAND UT
84312-9100
US

V. Phone/Fax

Practice location:
  • Phone: 435-257-2469
  • Fax:
Mailing address:
  • Phone: 435-257-2469
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number7960745-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: