Individual
ALYSSA NICOLE DEJONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
561 N GRAHAM ST UNIT 101, STEPHENVILLE, TX 76401-3555
(254) 965-2663
(254) 968-7979
Mailing address
561 N GRAHAM ST, STEPHENVILLE, TX 76401-3548
(254) 965-2663
(254) 968-7979
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA15009
TX
363AM0700X
Medical Physician Assistant
Primary
PA15009
TX
Other
Enumeration date
08/10/2020
Last updated
10/11/2023
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