Individual
ALYSSA DISOSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, AGACNP
Contact information
Practice address
121 LAKEVIEW CIR STE A, COVINGTON, LA 70433-7521
(985) 400-5483
Mailing address
162 PINE CREEK DR, MADISONVILLE, LA 70447-9679
(985) 502-8556
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
201773
LA
Other
Enumeration date
10/15/2024
Last updated
10/15/2024
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