Provider Demographics
NPI:1780910521
Name:OSBORNE-MCNEIL, ALEXIS MICHELLE (NMD)
Entity type:Individual
Prefix:DR
First Name:ALEXIS
Middle Name:MICHELLE
Last Name:OSBORNE-MCNEIL
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 E. INDIAN SCHOOL RD.
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014
Mailing Address - Country:US
Mailing Address - Phone:602-241-9105
Mailing Address - Fax:602-241-9104
Practice Address - Street 1:1000 E INDIAN SCHOOL RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014
Practice Address - Country:US
Practice Address - Phone:602-241-9105
Practice Address - Fax:602-241-9104
Is Sole Proprietor?:No
Enumeration Date:2009-10-29
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ09-1144175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath