Healthcare Provider Details

I. General information

NPI: 1376136309
Provider Name (Legal Business Name): CLAIRISSA ANNE ALEXANDER APNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2021
Last Update Date: 02/21/2024
Certification Date: 02/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9200 W WISCONSIN AVE
MILWAUKEE WI
53226-3522
US

IV. Provider business mailing address

215 W MAPLE ST APT 305
MILWAUKEE WI
53204-4048
US

V. Phone/Fax

Practice location:
  • Phone: 414-955-7040
  • Fax: 414-955-6211
Mailing address:
  • Phone: 262-744-1468
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number11184
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number23251930
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: