Individual
ALYSSA JANE SACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1111 11TH ST, HAWARDEN, IA 51023-1903
(712) 551-3100
Mailing address
1110 LUCAS AVE, PIERSON, IA 51048-8071
(515) 450-8335
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A171569
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A171569
IOWA ADVANCED REGISTERED NURSE PRACTITIONER LICENSE
IA
01
—
F08220001
AMERICAN ACADEMY OF NURSE PRACTITIONERS CERTIFICATION BOARD
IA
Enumeration date
10/24/2022
Last updated
10/24/2022
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