Provider Demographics
NPI:1245058874
Name:WESTMARK, ALEXIS CLARE (APRN)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:CLARE
Last Name:WESTMARK
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ALEXIS
Other - Middle Name:CLARE
Other - Last Name:SUMNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1851 N 9TH AVE STE B
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-5201
Mailing Address - Country:US
Mailing Address - Phone:229-339-3152
Mailing Address - Fax:
Practice Address - Street 1:1851 N 9TH AVE STE B
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-5201
Practice Address - Country:US
Practice Address - Phone:229-339-3152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11035578363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner