Provider Demographics
NPI:1376001537
Name:DAY, ALEXANDRA PATRICE (LVN)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:PATRICE
Last Name:DAY
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 GOLFCREST DR APT 237
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75604-3911
Mailing Address - Country:US
Mailing Address - Phone:903-452-9187
Mailing Address - Fax:
Practice Address - Street 1:715 GOLFCREST DR APT 237
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75604-3911
Practice Address - Country:US
Practice Address - Phone:903-452-9187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-06
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX347321164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX26083689OtherDRIVER'S LICENSE