Alexis Marie Wyeth, CRNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

SP030147 Issued in PA

Practice address

151 Stahl Rd
Southampton, PA 18966-3273

Phone

(215) 901-6112

NPI assigned

Jul 26, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1721952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1609605906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 STAHL RD",
            "city": "SOUTHAMPTON",
            "state": "PA",
            "postal_code": "189663273",
            "telephone_number": "215-901-6112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 STAHL RD",
            "city": "SOUTHAMPTON",
            "state": "PA",
            "postal_code": "189663273",
            "telephone_number": "215-901-6112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYETH",
        "first_name": "ALEXIS",
        "middle_name": "MARIE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-26",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP030147",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SP030147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theresa Wood
• Brian Anthony Woodring
• Workers' Choice Pharmacy (1st Choice Pharmacy LLC)
• Victoria Ann Wright
• Lisa Wunderle
• Hyung Yeo, MD
• Alexandra Yotter
• Syed Ali Zaidi, MD
• Michael Lee Zanders, PH.D
• Kimberly Zeuggin, LPC

• Acute Care Nurse Practitioner in Southampton, PA
• Providers in Southampton, PA by specialty
• Acute Care Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.