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General NPI Number Information
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NPI Number | 1104322544
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Entity Type | Individual
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Provider Name | ALYSSA RAE MCCUE RN
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Gender | Female
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Dates
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Enumeration Date | 04/04/2018
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Last Update Date | 04/04/2018
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Provider Practice Location Address
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Address Line | 1000 JUNGLES AVE
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City | AURORA
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State | IL
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Zip | 60505-1914
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Country | US
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Telephone | 630-299-8209
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Fax |
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Provider Business Mailing Address
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Address Line | 1397 CRIMSON LN
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City | YORKVILLE
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State | IL
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Zip | 60560-3073
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Country | US
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Telephone | 630-849-5914
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WS0200X
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Taxonomy Name | School Registered Nurse
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License Number | 041455085
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License Number State | IL
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