Healthcare Provider Details

I. General information

NPI: 1922707249
Provider Name (Legal Business Name): ALEXIS ALAYNE STOKES APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2023
Last Update Date: 02/24/2023
Certification Date: 11/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

877 S LILY DR UNIT B207
FRUIT HEIGHTS UT
84037-1976
US

IV. Provider business mailing address

877 S LILY DR UNIT B207
FRUIT HEIGHTS UT
84037-1976
US

V. Phone/Fax

Practice location:
  • Phone: 435-820-0904
  • Fax:
Mailing address:
  • Phone: 435-820-0904
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number10421945-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: