Provider Demographics
NPI:1245123728
Name:JANOTA GAINES, ALEXANDRA (AGACNP-BC)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:JANOTA GAINES
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:
Other - Last Name:JANOTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:S8636 COTTONWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-2329
Mailing Address - Country:US
Mailing Address - Phone:715-577-4174
Mailing Address - Fax:
Practice Address - Street 1:S8636 COTTONWOOD CIR
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-2329
Practice Address - Country:US
Practice Address - Phone:715-577-4174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program