Provider Demographics
NPI:1740978782
Name:GAY, ALEXANDRA MARIE
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:MARIE
Last Name:GAY
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 1:8680 OREGON RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MILLFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45761-9770
Mailing Address - Country:US
Mailing Address - Phone:701-580-8860
Mailing Address - Fax:
Practice Address - Street 1:8680 OREGON RIDGE RD
Practice Address - Street 2:
Practice Address - City:MILLFIELD
Practice Address - State:OH
Practice Address - Zip Code:45761-9770
Practice Address - Country:US
Practice Address - Phone:701-580-8860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-27
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No172A00000XOther Service ProvidersDriver