MEDICARE: ALEXIS BOZEK

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	363LF0000X	Family Nurse Practitioner	4704363539	MI

General Provider Information

NPI Number	:	1952111882
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXIS BOZEK

Provider Business Mailing Address
First Line	:	10850 E TRAVERSE HWY STE 1155
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49684-1363
Country	:	US
Telephone Number	:	231-268-0013
Fax Number	:	469-319-9379

Provider Business Practice Location Address
First Line	:	10850 E TRAVERSE HWY STE 1155
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49684-1363
Country	:	US
Telephone Number	:	231-268-0013
Fax Number	:	469-319-9379

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

Provider Enumeration Date	:	01/13/2025
Last Update Date	:	03/02/2026

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Directions to “ ALEXIS BOZEK ” Practice Location

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