Provider Demographics
NPI:1609241298
Name:ALEXIS, VERONICA (RN)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:ALEXIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 UPSILON ST
Mailing Address - Street 2:
Mailing Address - City:BELLE CHASSE
Mailing Address - State:LA
Mailing Address - Zip Code:70037-1747
Mailing Address - Country:US
Mailing Address - Phone:504-250-8162
Mailing Address - Fax:504-455-7626
Practice Address - Street 1:2637 EDENBORN AVE
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002
Practice Address - Country:US
Practice Address - Phone:504-650-5033
Practice Address - Fax:504-455-7626
Is Sole Proprietor?:No
Enumeration Date:2015-12-08
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA108595163WC1500X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health