MEDICARE: ALEXANDREA PRESBERRY

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
1	164W00000X	Licensed Practical Nurse	4703109509	MI

General Provider Information

NPI Number	:	1932450319
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDREA PRESBERRY

Provider Business Mailing Address
First Line	:	2021 CHRISTIE ST
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43606-3904
Country	:	US
Telephone Number	:	419-508-6993
Fax Number	:

Provider Business Practice Location Address
First Line	:	2021 CHRISTIE ST
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43606-3904
Country	:	US
Telephone Number	:	419-508-6993
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2012
Last Update Date	:	09/26/2012

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Directions to “ ALEXANDREA PRESBERRY ” Practice Location

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