Provider Demographics
NPI:1518749209
Name:MEJIA, ALYANNA (FNP)
Entity type:Individual
Prefix:
First Name:ALYANNA
Middle Name:
Last Name:MEJIA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:ALY
Other - Middle Name:
Other - Last Name:MEJIA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:427 N GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76240-4357
Mailing Address - Country:US
Mailing Address - Phone:224-578-0590
Mailing Address - Fax:
Practice Address - Street 1:427 N GRAND AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:TX
Practice Address - Zip Code:76240-4357
Practice Address - Country:US
Practice Address - Phone:940-584-1014
Practice Address - Fax:940-584-1013
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-17
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1139817363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner