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NPI Code Detail

MEDICARE: ALYSSA STOREY

MEDICARE: ALYSSA STOREY
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
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1528898343
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSSA STOREY
Provider Business Mailing Address
First Line : 6209 SHADYVIEW LN N
Second Line :
City : MAPLE GROVE
State : MN
Zip : 55311-4635
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 507 N 17TH ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53233-2104
Country : US
Telephone Number : 414-288-5688
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2024
Last Update Date : 08/06/2024

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Directions to “ ALYSSA STOREY ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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