Healthcare Provider Details

I. General information

NPI: 1558272666
Provider Name (Legal Business Name): ALEXIS COOKSEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1502 SOUTHPARK CT
COLUMBUS IN
47201-7489
US

IV. Provider business mailing address

151 E N 3RD ST
CARBON IN
47837
US

V. Phone/Fax

Practice location:
  • Phone: 812-350-0034
  • Fax: 812-379-8045
Mailing address:
  • Phone: 812-350-0034
  • Fax: 812-379-8045

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: