Provider Demographics
NPI:1962441774
Name:FOX, ALECIA (NP)
Entity Type:Individual
Prefix:
First Name:ALECIA
Middle Name:
Last Name:FOX
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 S EVERGREEN AVE
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:08096-2739
Mailing Address - Country:US
Mailing Address - Phone:856-686-4300
Mailing Address - Fax:
Practice Address - Street 1:7TH & CLAYTON AVENUES
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805
Practice Address - Country:US
Practice Address - Phone:302-421-4333
Practice Address - Fax:302-421-4858
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG0000250363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000978142Medicaid
DE1962441774Medicaid
DE1962441774Medicaid
DE0000978142Medicaid