Provider Demographics
NPI:1083867832
Name:ROD, ALEXIS E (FNP-C)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:E
Last Name:ROD
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:ALEXIS
Other - Middle Name:E
Other - Last Name:COY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:8000 5 MILE RD
Mailing Address - Street 2:STE 305
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45230-2163
Mailing Address - Country:US
Mailing Address - Phone:513-232-3500
Mailing Address - Fax:513-624-2704
Practice Address - Street 1:8000 5 MILE RD
Practice Address - Street 2:STE 305
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45230-2163
Practice Address - Country:US
Practice Address - Phone:513-232-3500
Practice Address - Fax:513-624-2704
Is Sole Proprietor?:No
Enumeration Date:2008-10-24
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN908019363LF0000X
OH11543363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0138299Medicaid
OHH174010OtherMEDICARE PTAN