Healthcare Provider Details

I. General information

NPI: 1336051663
Provider Name (Legal Business Name): ALIXANDRA HOPE FIDLER FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1562 W FIRST AVE
GRANDVIEW OH
43212
US

IV. Provider business mailing address

516 TOWNVIEW CIR W
MANSFIELD OH
44907-1140
US

V. Phone/Fax

Practice location:
  • Phone: 614-776-0625
  • Fax:
Mailing address:
  • Phone: 419-989-8112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0043125
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: