Provider Demographics
NPI:1942655790
Name:ALBRECHT, ALEXIS N (RN)
Entity Type:Individual
Prefix:MISS
First Name:ALEXIS
Middle Name:N
Last Name:ALBRECHT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1331 E GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:WISCONSIN RAPIDS
Mailing Address - State:WI
Mailing Address - Zip Code:54494-4660
Mailing Address - Country:US
Mailing Address - Phone:715-697-8887
Mailing Address - Fax:
Practice Address - Street 1:1331 E GRAND AVE
Practice Address - Street 2:
Practice Address - City:WISCONSIN RAPIDS
Practice Address - State:WI
Practice Address - Zip Code:54494-4660
Practice Address - Country:US
Practice Address - Phone:715-697-8887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-29
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI320428164W00000X
WI248931-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse