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General NPI Number Information
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NPI Number | 1366983314
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Entity Type | Individual
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Provider Name | ALYSSA PULLAN PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 03/10/2017
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Last Update Date | 05/11/2017
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Provider Practice Location Address
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Address Line | 78 COURTNEY AVE
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City | PAWTUCKET
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State | RI
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Zip | 02861-3935
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Country | US
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Telephone | 401-725-2264
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Fax |
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Provider Business Mailing Address
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Address Line | 180 WATERMAN AVE
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City | NORTH PROVIDENCE
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State | RI
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Zip | 02911-4100
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Country | US
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Telephone |
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN2275251
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN01459
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License Number State | RI
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