Deppong, Alyssa S

Deppong, Alyssa S is an individual health care provider with primary practice located at 12500 Aurora Dr , Pleasant Prairie WI 53158-1227. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Gastroenterology, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Deppong, Alyssa S can be contacted via phone (262) 857-5000.

Contact Information

Primary practice address
12500 Aurora Dr Pleasant Prairie WI 53158-1227
Phone: (262) 857-5000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 4736-23 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 4736-23 Wisconsin

Profile Details

NPI number 1538721451
LBN Legal business name Deppong, Alyssa S
Credentials PHYSICIAN ASSISTANT
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 1st, 2019
Last updated Dec 5th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538721451 NPPES
Wisconsin MEDICAID 100091500

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