MEDICARE: MRS. ZUE ALEXIA HEAD NURSE PRACTITIONER

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	363LF0000X	Family Nurse Practitioner	AP10915	AZ
2	363LF0000X	Family Nurse Practitioner	209.027295	IL

General Provider Information

NPI Number	:	1275034753
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ZUE ALEXIA HEAD NURSE PRACTITIONER

Provider Business Mailing Address
First Line	:	PO BOX 746715
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-6715
Country	:	US
Telephone Number	:	312-733-9730
Fax Number	:

Provider Business Practice Location Address
First Line	:	6918 W ARCHER AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60638-2337
Country	:	US
Telephone Number	:	773-667-3508
Fax Number	:

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

Provider Enumeration Date	:	02/21/2018
Last Update Date	:	06/13/2025

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