Healthcare Provider Details

I. General information

NPI: 1396682134
Provider Name (Legal Business Name): ALEXA L. ROSETTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1313 E OSBORN RD STE B-150
PHOENIX AZ
85014-5678
US

IV. Provider business mailing address

701 BERKLEY PKWY APT 2339
KANSAS CITY MO
64120-1528
US

V. Phone/Fax

Practice location:
  • Phone: 602-264-4431
  • Fax:
Mailing address:
  • Phone: 913-223-3932
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: