Provider Demographics
NPI:1043885494
Name:CHRISTERSON, ALEXA MICHELLE (RN)
Entity Type:Individual
Prefix:MS
First Name:ALEXA
Middle Name:MICHELLE
Last Name:CHRISTERSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 WALNUT AVE
Mailing Address - Street 2:
Mailing Address - City:REVERE
Mailing Address - State:MA
Mailing Address - Zip Code:02151-3564
Mailing Address - Country:US
Mailing Address - Phone:781-492-8679
Mailing Address - Fax:
Practice Address - Street 1:185 WALNUT AVE
Practice Address - Street 2:
Practice Address - City:REVERE
Practice Address - State:MA
Practice Address - Zip Code:02151-3564
Practice Address - Country:US
Practice Address - Phone:781-492-8679
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-26
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2297441163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse