Provider Demographics
NPI:1023529005
Name:SPINK, ALEXIS (RDN)
Entity type:Individual
Prefix:MRS
First Name:ALEXIS
Middle Name:
Last Name:SPINK
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:880 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:NH
Mailing Address - Zip Code:03825-6130
Mailing Address - Country:US
Mailing Address - Phone:603-767-4341
Mailing Address - Fax:
Practice Address - Street 1:323 GONIC RD STE 2A
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03839-5689
Practice Address - Country:US
Practice Address - Phone:603-332-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-18
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1164133V00000X
MA133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered