Provider Demographics
NPI:1891900528
Name:ALESSIA, GINA (RN, BSN,APN-CNS,CWCN)
Entity Type:Individual
Prefix:MS
First Name:GINA
Middle Name:
Last Name:ALESSIA
Suffix:
Gender:F
Credentials:RN, BSN,APN-CNS,CWCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 W 61ST AVE
Mailing Address - Street 2:
Mailing Address - City:HOBART
Mailing Address - State:IN
Mailing Address - Zip Code:46342-6490
Mailing Address - Country:US
Mailing Address - Phone:773-706-2306
Mailing Address - Fax:708-633-3306
Practice Address - Street 1:320 W 61ST AVE
Practice Address - Street 2:
Practice Address - City:HOBART
Practice Address - State:IN
Practice Address - Zip Code:46342-6490
Practice Address - Country:US
Practice Address - Phone:219-947-6448
Practice Address - Fax:219-947-6839
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2015-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL41251928163WE0900X
IN28211957A364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
No163WE0900XNursing Service ProvidersRegistered NurseEnterostomal Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201204640Medicaid