Provider Demographics
NPI:1760005565
Name:WEBER, ALEXIS ANN
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:ANN
Last Name:WEBER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 GROVE LN APT 215B
Mailing Address - Street 2:
Mailing Address - City:WHITE HOUSE
Mailing Address - State:TN
Mailing Address - Zip Code:37188-2201
Mailing Address - Country:US
Mailing Address - Phone:615-979-7015
Mailing Address - Fax:
Practice Address - Street 1:332 SUMNER HALL DR
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-3129
Practice Address - Country:US
Practice Address - Phone:615-460-4500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-27
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator