Provider Demographics
NPI:1447000369
Name:ALEXIS, NERLANDE ROSEDALIES
Entity type:Individual
Prefix:
First Name:NERLANDE
Middle Name:ROSEDALIES
Last Name:ALEXIS
Suffix:
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 1:2565 CHERRYWOOD CT SW
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:MI
Mailing Address - Zip Code:49519-2217
Mailing Address - Country:US
Mailing Address - Phone:616-295-7513
Mailing Address - Fax:
Practice Address - Street 1:2565 CHERRYWOOD CT SW
Practice Address - Street 2:
Practice Address - City:WYOMING
Practice Address - State:MI
Practice Address - Zip Code:49519-2217
Practice Address - Country:US
Practice Address - Phone:616-295-7513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant