Provider Demographics
NPI:1689897498
Name:ALEXANDER, MICHELLE META (RN, NP)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:META
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:RN, NP
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:META
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, NP
Mailing Address - Street 1:8400 ROSETTO RD
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-2944
Mailing Address - Country:US
Mailing Address - Phone:916-791-6299
Mailing Address - Fax:
Practice Address - Street 1:5700 WATT AVE
Practice Address - Street 2:
Practice Address - City:NORTH HIGHLANDS
Practice Address - State:CA
Practice Address - Zip Code:95660-4752
Practice Address - Country:US
Practice Address - Phone:916-332-2402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA639508163W00000X
CA16394363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner