| NPI | 1538642863 |
|---|---|
| Former Name | ALYSSA LAINE VANDERSLICE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2024019220) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CO APN.0994741-NP) |
| Enumeration Date | 2018-09-12 |
| Last Update Date | 2025-08-07 |