Healthcare Provider Details

I. General information

NPI: 1285033076
Provider Name (Legal Business Name): LOVELEENA ALEX NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2014
Last Update Date: 05/16/2022
Certification Date: 05/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4460 S LINDBERGH BLVD
SAINT LOUIS MO
63127-1647
US

IV. Provider business mailing address

7210 W MAIN ST
BELLEVILLE IL
62223-3038
US

V. Phone/Fax

Practice location:
  • Phone: 314-843-7557
  • Fax:
Mailing address:
  • Phone: 618-398-8840
  • Fax: 618-398-8847

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209011557
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2020007237
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: