MEDICARE: MRS. ALEXA TAYLOR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	12224	NM

General Provider Information

NPI Number	:	1154073021
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALEXA TAYLOR

Provider Business Mailing Address
First Line	:	2430 JANET ANN LN
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88007-5176
Country	:	US
Telephone Number	:	575-650-3403
Fax Number	:

Provider Business Practice Location Address
First Line	:	920 N ALAMEDA BLVD
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88005-2291
Country	:	US
Telephone Number	:	575-520-1522
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/21/2022
Last Update Date	:	01/21/2022

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Directions to “ MRS. ALEXA TAYLOR ” Practice Location

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