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General NPI Number Information
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NPI Number | 1023727609
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Entity Type | Individual
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Provider Name | ALEXA NOELLE REEDY APRN
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Gender | Female
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Dates
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Enumeration Date | 11/22/2022
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 1350 HICKORY ST
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City | MELBOURNE
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State | FL
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Zip | 32901-3224
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Country | US
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Telephone | 317-805-4102
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Fax |
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Provider Business Mailing Address
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Address Line | 2488 BONNY DR
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City | COCOA
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State | FL
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Zip | 32926-5345
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Country | US
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Telephone | 321-482-6967
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 11023160
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 9381536
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License Number State | FL
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