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General NPI Number Information
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NPI Number | 1538054168
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Entity Type | Individual
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Provider Name | ALEXIS MARIE HARSTAD APRN
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Gender | Female
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Dates
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Enumeration Date | 06/12/2025
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Last Update Date | 08/12/2025
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Provider Practice Location Address
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Address Line | 2600 WESTHALL LN STE 4
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City | MAITLAND
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State | FL
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Zip | 32751-7102
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Country | US
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Telephone | 407-200-2355
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Fax | 407-200-4947
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Provider Business Mailing Address
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Address Line | 2504 UNITY TREE DR
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City | EDGEWATER
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State | FL
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Zip | 32141-4812
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Country | US
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Telephone | 703-415-6781
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11040111
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License Number State | FL
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