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General NPI Number Information
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NPI Number | 1356726046
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Entity Type | Individual
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Provider Name | ALISSA S ROE NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 07/23/2015
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Last Update Date | 04/27/2021
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Provider Practice Location Address
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Address Line | 945 BETHESDA DR STE 130
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City | ZANESVILLE
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State | OH
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Zip | 43701-1880
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Country | US
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Telephone | 740-454-4004
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Fax |
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Provider Business Mailing Address
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Address Line | 1460 COLBURN DR
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City | ZANESVILLE
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State | OH
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Zip | 43701-7053
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Country | US
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Telephone | 740-705-2003
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN.CNP.17765
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License Number State | OH
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