Healthcare Provider Details

I. General information

NPI: 1750852620
Provider Name (Legal Business Name): ALEXANDRA RAE HARRIS C.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALEXANDRA RAE BUEHRLE C.N.P.

II. Dates (important events)

Enumeration Date: 12/17/2018
Last Update Date: 07/31/2023
Certification Date: 07/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9485 MENTOR AVE STE 210
MENTOR OH
44060-8723
US

IV. Provider business mailing address

14831 HITCHING POST LN
NOVELTY OH
44072-9534
US

V. Phone/Fax

Practice location:
  • Phone: 440-255-5571
  • Fax: 440-205-5744
Mailing address:
  • Phone: 330-321-2853
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.023690
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License NumberAPRN.CNP.023690
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: