Provider Demographics
NPI:1881186096
Name:LEMOINE, ALEXANDRA GABRIELLE (ARNP)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:GABRIELLE
Last Name:LEMOINE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1032 MAR WALT DR UNIT 230
Mailing Address - Street 2:
Mailing Address - City:FT WALTON BCH
Mailing Address - State:FL
Mailing Address - Zip Code:32547-6661
Mailing Address - Country:US
Mailing Address - Phone:850-862-3194
Mailing Address - Fax:850-565-0270
Practice Address - Street 1:1032 MAR WALT DR UNIT 230
Practice Address - Street 2:
Practice Address - City:FT WALTON BCH
Practice Address - State:FL
Practice Address - Zip Code:32547-6661
Practice Address - Country:US
Practice Address - Phone:850-862-3194
Practice Address - Fax:850-565-0270
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-04
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9251216363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology