Provider Demographics
NPI:1568100147
Name:MORPEAU, ALEXIS DEANGELA
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:DEANGELA
Last Name:MORPEAU
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 1:2680 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-3913
Mailing Address - Country:US
Mailing Address - Phone:516-330-7241
Mailing Address - Fax:
Practice Address - Street 1:2680 GRAND AVE
Practice Address - Street 2:
Practice Address - City:BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510-3913
Practice Address - Country:US
Practice Address - Phone:516-330-7241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-24
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY339684-01164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse