Provider Demographics
NPI:1174031843
Name:ROEMKE, ALEXANDRIA JOANNE (NP)
Entity Type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:JOANNE
Last Name:ROEMKE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ALEXANDRIA
Other - Middle Name:JOANNE
Other - Last Name:SANFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:400 N MOUNT ZION RD
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:IN
Mailing Address - Zip Code:46052-9497
Mailing Address - Country:US
Mailing Address - Phone:765-335-0123
Mailing Address - Fax:765-335-0127
Practice Address - Street 1:400 N MOUNT ZION RD
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:IN
Practice Address - Zip Code:46052-9497
Practice Address - Country:US
Practice Address - Phone:765-335-0123
Practice Address - Fax:765-335-0127
Is Sole Proprietor?:No
Enumeration Date:2018-01-16
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71007736A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily