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NPI Code Detail

MEDICARE: ALEXANDRA P PETIT

MEDICARE: ALEXANDRA P PETIT
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
1390200000XStudent in an Organized Health Care Education/Training Program
2363LF0000XFamily Nurse PractitionerAPRN.CNP.0029787OH

General Provider Information

NPI Number : 1528605672
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXANDRA P PETIT
Provider Business Mailing Address
First Line : 4605 MONTGOMERY RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45212-2607
Country : US
Telephone Number : 513-853-9700
Fax Number :
Provider Business Practice Location Address
First Line : 4605 MONTGOMERY RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45212-2607
Country : US
Telephone Number : 513-853-9700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2019
Last Update Date : 09/13/2022

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Directions to “ ALEXANDRA P PETIT ” Practice Location

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