Provider Demographics
NPI:1205409067
Name:RODKEY, ALEXANDRA PEZZI (RN, CRNA)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:PEZZI
Last Name:RODKEY
Suffix:
Gender:F
Credentials:RN, CRNA
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:LAUREN
Other - Last Name:PEZZI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8024 115TH STREET CT E
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98373-4618
Mailing Address - Country:US
Mailing Address - Phone:215-350-1288
Mailing Address - Fax:
Practice Address - Street 1:9040 JACKSON AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-3307
Practice Address - Country:US
Practice Address - Phone:253-968-2252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-20
Last Update Date:2023-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1038631163W00000X
VA24184424367500000X
WAAP61431607367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
No163W00000XNursing Service ProvidersRegistered Nurse