Healthcare Provider Details

I. General information

NPI: 1467362251
Provider Name (Legal Business Name): ALEXIA LYNN SUTTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4213 O ST
LINCOLN NE
68510-1751
US

IV. Provider business mailing address

4213 O ST
LINCOLN NE
68510-1751
US

V. Phone/Fax

Practice location:
  • Phone: 402-419-4850
  • Fax: 531-500-2407
Mailing address:
  • Phone: 402-419-4850
  • Fax: 531-500-2407

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: