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General NPI Number Information
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NPI Number | 1902586068
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Entity Type | Individual
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Provider Name | ALYSE MARIE ALEXANDER CNP
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Gender | Female
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Dates
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Enumeration Date | 07/24/2023
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 22614 STATE ROUTE 51 W
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City | GENOA
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State | OH
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Zip | 43430-1143
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Country | US
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Telephone | 419-855-7772
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Fax |
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Provider Business Mailing Address
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Address Line | 1115 COUNTRY VIEW LN APT 16C
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City | TOLEDO
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State | OH
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Zip | 43615-8310
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Country | US
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Telephone | 828-447-4149
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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 | 0033823
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License Number State | OH
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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 | 4704407240
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License Number State | MI
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