Provider Demographics
NPI:1558086439
Name:GREENSTEIN, ALEXIS JAN
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:JAN
Last Name:GREENSTEIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1708 ASSUMPTION DR
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-1501
Mailing Address - Country:US
Mailing Address - Phone:701-400-8060
Mailing Address - Fax:
Practice Address - Street 1:1708 ASSUMPTION DR
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-1501
Practice Address - Country:US
Practice Address - Phone:701-400-8060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-04
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion