Provider Demographics
NPI:1881086338
Name:ALEXIS, ALERTTE (LPN)
Entity type:Individual
Prefix:
First Name:ALERTTE
Middle Name:
Last Name:ALEXIS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:ALERTTE
Other - Middle Name:
Other - Last Name:ALEXIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1526 ALBANY AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-2019
Mailing Address - Country:US
Mailing Address - Phone:347-791-1357
Mailing Address - Fax:
Practice Address - Street 1:1526 ALBANY AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-2019
Practice Address - Country:US
Practice Address - Phone:347-791-1357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-20
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY318924-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse