Provider Demographics
NPI:1750852620
Name:HARRIS, ALEXANDRA RAE (CNP)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:RAE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:RAE
Other - Last Name:BUEHRLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CNP
Mailing Address - Street 1:14831 HITCHING POST LN
Mailing Address - Street 2:
Mailing Address - City:NOVELTY
Mailing Address - State:OH
Mailing Address - Zip Code:44072-9534
Mailing Address - Country:US
Mailing Address - Phone:330-321-2853
Mailing Address - Fax:
Practice Address - Street 1:9485 MENTOR AVE STE 210
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-8723
Practice Address - Country:US
Practice Address - Phone:440-255-5571
Practice Address - Fax:440-205-5744
Is Sole Proprietor?:No
Enumeration Date:2018-12-17
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.023690207NS0135X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology