Provider Demographics
NPI:1396638169
Name:MACCANI, ALEXA MACKENZIE
Entity type:Individual
Prefix:
First Name:ALEXA
Middle Name:MACKENZIE
Last Name:MACCANI
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 1:12237 TOSCANA WAY APT 103
Mailing Address - Street 2:
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34135-9254
Mailing Address - Country:US
Mailing Address - Phone:719-242-7824
Mailing Address - Fax:
Practice Address - Street 1:12237 TOSCANA WAY APT 103
Practice Address - Street 2:
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34135-9254
Practice Address - Country:US
Practice Address - Phone:719-242-7824
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-31
Last Update Date:2025-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9600676163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse