Provider Demographics
NPI:1407249527
Name:COGGINS, ALEXUS MARTEL (CNA)
Entity Type:Individual
Prefix:MRS
First Name:ALEXUS
Middle Name:MARTEL
Last Name:COGGINS
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6305 CARLISLE SQ
Mailing Address - Street 2:201-A
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-3754
Mailing Address - Country:US
Mailing Address - Phone:513-884-3339
Mailing Address - Fax:
Practice Address - Street 1:6305 CARLISLE SQ
Practice Address - Street 2:201-A
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-3754
Practice Address - Country:US
Practice Address - Phone:513-884-3339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-13
Last Update Date:2015-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1401170073376K00000X
OH401668280714376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide