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General NPI Number Information
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NPI Number | 1831704089
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Entity Type | Individual
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Provider Name | ALEXIS MARGARET MACKLIN CRNP
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Gender | Female
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Dates
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Enumeration Date | 09/14/2020
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Last Update Date | 10/26/2022
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Provider Practice Location Address
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Address Line | 12902 USF MAGNOLIA DR
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City | TAMPA
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State | FL
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Zip | 33612-9416
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Country | US
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Telephone |
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Fax |
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Provider Business Mailing Address
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Address Line | 305 GEORGETOWNE CT
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City | WEXFORD
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State | PA
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Zip | 15090-8660
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Country | US
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Telephone | 724-630-5278
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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 | SP022357
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11021577
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License Number State | FL
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