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NPI Code Detail

MEDICARE: ALYSSA VECCHIONE HAYCOCK MSN, APRN, FNP-C

MEDICARE: ALYSSA VECCHIONE HAYCOCK MSN, APRN, FNP-C
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
1363LF0000XFamily Nurse Practitioner1010285TX

General Provider Information

NPI Number : 1982216024
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSSA VECCHIONE HAYCOCK MSN, APRN, FNP-C
Provider Business Mailing Address
First Line : 6331 PROSPECT AVE
Second Line :
City : DALLAS
State : TX
Zip : 75214-3938
Country : US
Telephone Number : 214-821-6331
Fax Number :
Provider Business Practice Location Address
First Line : 6331 PROSPECT AVE
Second Line :
City : DALLAS
State : TX
Zip : 75214-3938
Country : US
Telephone Number : 214-821-6331
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2020
Last Update Date : 08/19/2020

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