Provider Demographics
NPI:1134553167
Name:BOBEK, ALEXIS ANNE (APRN)
Entity type:Individual
Prefix:MS
First Name:ALEXIS
Middle Name:ANNE
Last Name:BOBEK
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 FENNER HILL RD
Mailing Address - Street 2:
Mailing Address - City:HOPE VALLEY
Mailing Address - State:RI
Mailing Address - Zip Code:02832-1227
Mailing Address - Country:US
Mailing Address - Phone:508-572-4110
Mailing Address - Fax:
Practice Address - Street 1:85 BEACH ST
Practice Address - Street 2:BUILDING B
Practice Address - City:WESTERLY
Practice Address - State:RI
Practice Address - Zip Code:02891-2717
Practice Address - Country:US
Practice Address - Phone:401-596-6866
Practice Address - Fax:401-596-0493
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-27
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN00130364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult