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NPI Code Detail

MEDICARE: ALYSSA BEVINGTON

MEDICARE: ALYSSA BEVINGTON
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
1374U00000XHome Health Aide

General Provider Information

NPI Number : 1609628122
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSSA BEVINGTON
Provider Business Mailing Address
First Line : 2569 MONTCLAIR AVE
Second Line :
City : WOOSTER
State : OH
Zip : 44691-1378
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2569 MONTCLAIR AVE
Second Line :
City : WOOSTER
State : OH
Zip : 44691-1378
Country : US
Telephone Number : 330-749-2049
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2024
Last Update Date : 04/05/2024

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Directions to “ ALYSSA BEVINGTON ” Practice Location

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