Provider Demographics
NPI:1376303255
Name:WOOD, ALEXIS (NURSE ASSISTANT)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:WOOD
Suffix:
Gender:F
Credentials:NURSE ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18315 MARCELLA RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44119-2621
Mailing Address - Country:US
Mailing Address - Phone:216-894-5022
Mailing Address - Fax:
Practice Address - Street 1:18315 MARCELLA RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44119-2621
Practice Address - Country:US
Practice Address - Phone:216-894-5022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH600575850623376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide