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General NPI Number Information
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NPI Number | 1508411281
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Entity Type | Individual
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Provider Name | ALYSSA ROSE CORKREAN APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 08/08/2019
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | 32713 COUNTY ROAD 473
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City | LEESBURG
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State | FL
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Zip | 34788-8856
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Country | US
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Telephone | 352-742-8080
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Fax |
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Provider Business Mailing Address
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Address Line | 9381 SILVER LAKE DR
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City | LEESBURG
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State | FL
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Zip | 34788-3407
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Country | US
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Telephone | 813-382-5703
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN11003472
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11003472
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License Number State | FL
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