Provider Demographics
NPI:1447018486
Name:DOWELL, ALLYSE NICOLE (FNP-C)
Entity type:Individual
Prefix:
First Name:ALLYSE
Middle Name:NICOLE
Last Name:DOWELL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 NE NORTHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:GLADSTONE
Mailing Address - State:MO
Mailing Address - Zip Code:64118-3616
Mailing Address - Country:US
Mailing Address - Phone:816-813-3797
Mailing Address - Fax:
Practice Address - Street 1:601 S US HIGHWAY 169
Practice Address - Street 2:
Practice Address - City:SMITHVILLE
Practice Address - State:MO
Practice Address - Zip Code:64089-9317
Practice Address - Country:US
Practice Address - Phone:816-532-7242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-12
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024006640363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily