Fredbo, Alyssa Irene
Fredbo, Alyssa Irene is an sole proprietor health care provider with primary practice located at 50 N Medical Dr , Salt Lake City UT 84132-0001. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Fredbo, Alyssa Irene can be contacted via phone (651) 323-8334.Contact Information
Primary practice address
50 N Medical Dr
Salt Lake City UT 84132-0001
Phone: (651) 323-8334
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | 13455633-1206 | Utah |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 13455633-1206 | Utah |
Profile Details
| NPI number | 1376226936 |
|---|---|
| LBN Legal business name | Fredbo, Alyssa Irene |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 10th, 2023 |
| Last updated | Mar 4th, 2024 - about last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1376226936 | NPPES |
| Utah | Other | 2018031454 | EMT |
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