Provider Demographics
NPI:1881386761
Name:WENGER, ALEXIS ERIN
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:ERIN
Last Name:WENGER
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 1:5463 COUNTY ROAD 57
Mailing Address - Street 2:
Mailing Address - City:GALION
Mailing Address - State:OH
Mailing Address - Zip Code:44833-9036
Mailing Address - Country:US
Mailing Address - Phone:419-631-3009
Mailing Address - Fax:
Practice Address - Street 1:5463 COUNTY ROAD 57
Practice Address - Street 2:
Practice Address - City:GALION
Practice Address - State:OH
Practice Address - Zip Code:44833-9036
Practice Address - Country:US
Practice Address - Phone:419-631-3009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No347C00000XTransportation ServicesPrivate Vehicle