Provider Demographics
NPI:1811769706
Name:SIFUENTES, ALEXIS DANYEL (APRN, CNM)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:DANYEL
Last Name:SIFUENTES
Suffix:
Gender:F
Credentials:APRN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:851 GREENSIDE DR APT 3319
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-1159
Mailing Address - Country:US
Mailing Address - Phone:361-960-8132
Mailing Address - Fax:
Practice Address - Street 1:406 W MAIN ST
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-2714
Practice Address - Country:US
Practice Address - Phone:214-495-9911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1139473367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife