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General NPI Number Information
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NPI Number | 1700475951
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Entity Type | Individual
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Provider Name | ALYSSA MARIE CARTIN PA
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Gender | Female
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Dates
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Enumeration Date | 01/12/2021
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Last Update Date | 11/07/2024
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Provider Practice Location Address
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Address Line | 3118 S LAFOUNTAIN ST
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City | KOKOMO
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State | IN
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Zip | 46902-3710
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Country | US
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Telephone | 765-864-4160
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Fax | 765-400-4467
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Provider Business Mailing Address
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Address Line | 8003 CASTLEWAY DR
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City | INDIANAPOLIS
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State | IN
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Zip | 46250-1946
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Country | US
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Telephone | 317-576-1335
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Fax | 317-343-6562
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 10003323A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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