Provider Demographics
NPI:1588026629
Name:SUITOR, ALEXANDRIA JUNE (RN)
Entity type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:JUNE
Last Name:SUITOR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ALEXANDRIA
Other - Middle Name:JUNE
Other - Last Name:NEEDHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:29023 STONERIDGE TER
Mailing Address - Street 2:
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92530-1753
Mailing Address - Country:US
Mailing Address - Phone:951-454-1429
Mailing Address - Fax:
Practice Address - Street 1:29023 STONERIDGE TER
Practice Address - Street 2:
Practice Address - City:LAKE ELSINORE
Practice Address - State:CA
Practice Address - Zip Code:92530-1753
Practice Address - Country:US
Practice Address - Phone:951-454-1429
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-28
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95081435163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse