Provider Demographics
NPI:1417673260
Name:BROWNELL, ALEXANDRIA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:
Last Name:BROWNELL
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11000 S EASTERN AVE APT 2627
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-2969
Mailing Address - Country:US
Mailing Address - Phone:808-212-5019
Mailing Address - Fax:
Practice Address - Street 1:1395 RAIDERS WAY STE 140
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4615
Practice Address - Country:US
Practice Address - Phone:725-241-6800
Practice Address - Fax:725-241-6801
Is Sole Proprietor?:No
Enumeration Date:2022-10-13
Last Update Date:2023-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4941225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist