Provider Demographics
NPI:1508501099
Name:CRAIN, ALYSSA KATHLEEN (MD)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:KATHLEEN
Last Name:CRAIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5056 THOROUGHBRED LN
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4225
Mailing Address - Country:US
Mailing Address - Phone:615-373-3337
Mailing Address - Fax:615-373-3782
Practice Address - Street 1:5056 THOROUGHBRED LN
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-4225
Practice Address - Country:US
Practice Address - Phone:615-373-3337
Practice Address - Fax:615-373-3782
Is Sole Proprietor?:No
Enumeration Date:2022-04-29
Last Update Date:2025-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TN73606208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program