Alyssa Ausnehmer, APRN

Individual provider Active NPI Pediatric Nurse Practitioner · Loxahatchee, FL

NPI 1760905285 · NPPES record last updated Feb 19, 2021

Key facts

NPI
1760905285
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Nurse Practitioner 363LP0200X
License
ARNP9344494 (FL)
Practice address
12959 Palms West Dr Ste 120
Loxahatchee, FL 33470-4938
Phone
(561) 753-8888
Fax
(561) 795-5004
NPI assigned
Jul 18, 2017
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP9344494FLMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Edwin Liu, MD PA Single Specialty Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner
Group: 193400000X SINGLE SPECIALTY GROUP
363LP0200X ARNP9344494 FL Yes

Addresses

Primary practice location

12959 Palms West Dr Ste 120
Loxahatchee, FL 33470-4938

Mailing address

12959 Palms West Dr Ste 120
Loxahatchee, FL 33470-4938
Phone (561) 753-8888

Other identifiers

IdentifierTypeStateIssuer
021630600MedicaidFL

Other providers in Loxahatchee, FL

All providers in Loxahatchee, FL · Pediatric Nurse Practitioner in Florida

Sources for this page

Verify at the official NPI Registry.