Individual
ALYSSA ANN MALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP/FNP
Contact information
Practice address
305 1ST ST E, CONOVER, NC 28613-1715
(828) 464-3821
Mailing address
100 KIMEL FOREST DR, WINSTON SALEM, NC 27103-6074
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
337035
NC
363L00000X
Nurse Practitioner
Primary
5022454
NC
363LF0000X
Family Nurse Practitioner
5022454
NC
Other
Enumeration date
03/26/2025
Last updated
08/07/2025
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