Provider Demographics
NPI:1659770105
Name:SPINA, ALEXIS KIRSTEN (PHARMD)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:KIRSTEN
Last Name:SPINA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 JILL DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15227-1337
Mailing Address - Country:US
Mailing Address - Phone:412-496-5477
Mailing Address - Fax:
Practice Address - Street 1:600 CHAUVET DR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15275-1043
Practice Address - Country:US
Practice Address - Phone:412-490-0802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-21
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP449123183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist