Provider Demographics
NPI:1073498325
Name:FEARS, ALEXANDRIA AZUERA I
Entity type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:AZUERA
Last Name:FEARS
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2405 N LINN ST
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61604-3627
Mailing Address - Country:US
Mailing Address - Phone:815-302-1246
Mailing Address - Fax:
Practice Address - Street 1:2405 N LINN ST
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61604-3627
Practice Address - Country:US
Practice Address - Phone:815-302-1246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-06
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide