Provider Demographics
NPI:1679036388
Name:SKERSKE, ALEXANDRA (FNP-BC)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:SKERSKE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56612 EDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48316-5834
Mailing Address - Country:US
Mailing Address - Phone:586-206-2431
Mailing Address - Fax:
Practice Address - Street 1:56612 EDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48316-5834
Practice Address - Country:US
Practice Address - Phone:586-206-2431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-09
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704302581363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner