Alexis Johnson
Individual provider Active NPI Licensed Practical Nurse · Phelps, NY
NPI 1790143345 · NPPES record last updated Feb 10, 2016
Key facts
- NPI
- 1790143345
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 320357 (NY)
- Practice address
- 394 Bostwick Rd
Phelps, NY 14532-9309 - Phone
- (315) 759-4166
- NPI assigned
- Feb 10, 2016
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 320357 | NY | Yes |
Addresses
Primary practice location
394 Bostwick Rd
Phelps, NY 14532-9309
Mailing address
394 Bostwick Rd
Phelps, NY 14532-9309
Phone (315) 759-4166
Other providers in Phelps, NY
- Emanuel Y Li, MD PC
- Amanda Ferrell
- Lisa Marie Fox
- Damien Joel Haseley
- Miranda Mae Hoover
- Samantha Willow Lewis
- Jeffrey Mathias
- Patricia Ann Oneil
- Phelps Ambulance, Inc.
- Phelps Hometown Pharmacy LLC
All providers in Phelps, NY · Licensed Practical Nurse in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 10, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.