Provider Demographics
NPI:1770323909
Name:EHRNFELT, ALEXANDRA ANNE
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:ANNE
Last Name:EHRNFELT
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 1:15403 DRAKE RD
Mailing Address - Street 2:
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44136-7755
Mailing Address - Country:US
Mailing Address - Phone:440-465-4953
Mailing Address - Fax:
Practice Address - Street 1:15403 DRAKE RD
Practice Address - Street 2:
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44136-7755
Practice Address - Country:US
Practice Address - Phone:440-465-4953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-27
Last Update Date:2024-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0036146363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily