Healthcare Provider Details

I. General information

NPI: 1669920872
Provider Name (Legal Business Name): ALEXIS DUKES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2016
Last Update Date: 09/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3570 ROBROY DR APT 4
CINCINNATI OH
45247-7047
US

IV. Provider business mailing address

3570 ROBROY DR APT 4
CINCINNATI OH
45247-7047
US

V. Phone/Fax

Practice location:
  • Phone: 513-430-5742
  • Fax:
Mailing address:
  • Phone: 513-430-5742
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number400887540409
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: