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NPI Code Detail

MEDICARE: ALEXA PETTIT

MEDICARE: ALEXA PETTIT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist46TR01180400NJ
2225X00000XOccupational Therapist17771NC

General Provider Information

NPI Number : 1255202230
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXA PETTIT
Provider Business Mailing Address
First Line : 3611 BEVERLY COVE WAY APT 208
Second Line :
City : WILMINGTON
State : NC
Zip : 28412-0829
Country : US
Telephone Number : 973-525-2040
Fax Number :
Provider Business Practice Location Address
First Line : 3901 WRIGHTSVILLE AVE STE 120
Second Line :
City : WILMINGTON
State : NC
Zip : 28403-6256
Country : US
Telephone Number : 910-679-8385
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2025
Last Update Date : 03/02/2026

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Directions to “ ALEXA PETTIT ” Practice Location

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