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Individual

ALYSSE SKY BLIGHT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
485 S DOBSON RD STE 101, CHANDLER, AZ 85224-5603
(480) 728-4981
(480) 728-4985
Mailing address
PO BOX 33269, PHOENIX, AZ 85067-3269
(602) 406-4786
(916) 636-4358

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
8224
AZ
363A00000X
Physician Assistant
363AM0700X
Medical Physician Assistant
Primary
8224
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
083156
AZ
Enumeration date
11/10/2020
Last updated
11/06/2024
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