=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093678856
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALLYSSA RAKEL MUSZYNSKI
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/08/2025
-----------------------------------------------------
Last Update Date | 12/08/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 31684 N RED ROCK TRL
-----------------------------------------------------
City | SAN TAN VALLEY
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85143-6340
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 901-692-2279
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 31684 N RED ROCK TRL
-----------------------------------------------------
City | SAN TAN VALLEY
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85143-6340
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | 251080
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 390200000X
-----------------------------------------------------
Taxonomy Name | Student in an Organized Health Care Education/Training Program
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------