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NPI Code Detail

MEDICARE: ALISSA KATHLEEN PRIOR

MEDICARE: ALISSA KATHLEEN PRIOR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1154985497
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALISSA KATHLEEN PRIOR
Provider Business Mailing Address
First Line : 2048 FULTON RD APT 217
Second Line :
City : CLEVELAND
State : OH
Zip : 44113-3968
Country : US
Telephone Number : 614-571-3950
Fax Number :
Provider Business Practice Location Address
First Line : 11100 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44106-1716
Country : US
Telephone Number : 216-868-8792
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2019
Last Update Date : 06/19/2023

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Directions to “ ALISSA KATHLEEN PRIOR ” Practice Location

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