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General NPI Number Information
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NPI Number | 1619775889
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Entity Type | Individual
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Provider Name | ALYSSA DUCKWORTH
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Gender | Female
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Dates
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Enumeration Date | 03/04/2025
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Last Update Date | 03/04/2025
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Provider Practice Location Address
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Address Line | 780 STEWART AVE
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City | COLUMBUS
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State | OH
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Zip | 43206-2950
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Country | US
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Telephone | 614-795-7591
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Fax |
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Provider Business Mailing Address
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Address Line | 780 STEWART AVE
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City | COLUMBUS
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State | OH
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Zip | 43206-2950
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Country | US
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Telephone | 614-795-7591
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 374J00000X
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Taxonomy Name | Doula
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 184292
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License Number State | OH
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