Provider Demographics
NPI:1376301135
Name:ALEXANDER, TASEY T
Entity type:Individual
Prefix:MS
First Name:TASEY
Middle Name:T
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3414 MOSS ST STE E
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70507-6107
Mailing Address - Country:US
Mailing Address - Phone:337-324-8506
Mailing Address - Fax:337-324-8507
Practice Address - Street 1:3414 MOSS ST STE E
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70507-6107
Practice Address - Country:US
Practice Address - Phone:337-324-8506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-07
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
253Z00000X, 374U00000X
LA22037861353747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No253Z00000XAgenciesIn Home Supportive Care
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant