Provider Demographics
NPI:1750917795
Name:ABELN, ALEXIS (BSN, RN, IBCLC, CCE)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:ABELN
Suffix:
Gender:F
Credentials:BSN, RN, IBCLC, CCE
Other - Prefix:
Other - First Name:LEXI
Other - Middle Name:
Other - Last Name:ABELN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:69 ACRI MEADOW RD
Mailing Address - Street 2:
Mailing Address - City:ENOLA
Mailing Address - State:PA
Mailing Address - Zip Code:17025-1902
Mailing Address - Country:US
Mailing Address - Phone:717-731-0606
Mailing Address - Fax:
Practice Address - Street 1:69 ACRI MEADOW RD
Practice Address - Street 2:
Practice Address - City:ENOLA
Practice Address - State:PA
Practice Address - Zip Code:17025-1902
Practice Address - Country:US
Practice Address - Phone:717-731-0606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-22
Last Update Date:2020-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN576695163W00000X, 163WC1600X, 163WI0500X, 163WP1700X, 163WL0100X
174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163W00000XNursing Service ProvidersRegistered Nurse
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy
No163WP1700XNursing Service ProvidersRegistered NursePerinatal
No174H00000XOther Service ProvidersHealth Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
L-68635OtherIBLCE