Provider Demographics
NPI:1447726377
Name:CRAFT, ALYSSE ROCHELLE (APRN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:ALYSSE
Middle Name:ROCHELLE
Last Name:CRAFT
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1711 BIG BEND DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-7475
Mailing Address - Country:US
Mailing Address - Phone:727-271-8997
Mailing Address - Fax:
Practice Address - Street 1:5339 N INTERSTATE 35 STE 100
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-2558
Practice Address - Country:US
Practice Address - Phone:512-628-1898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-18
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP139596363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health