Individual
MS. ALYSSIA TYRELL TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DOD, NPI
Contact information
Practice address
P.O. BOX 3041, MARTINSVILLE, VA 24115-3041
(540) 505-9397
Mailing address
P.O. BOX 3041, MARTINSVILLE, VA 24115-3041
(540) 505-9397
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
080020440032
ZZ
171W00000X
Contractor
10492248643
VA
246Z00000X
Other Specialist/Technologist
10492248643
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
089020440032
—
VA
01
—
203128076
INSURANCE INC
NY
Enumeration date
07/01/2025
Last updated
07/01/2025
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