Provider Demographics
NPI:1578446621
Name:PALLAT, ALEXIS RAE
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:RAE
Last Name:PALLAT
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 1:715 LEGACY DR APT 8
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-7036
Mailing Address - Country:US
Mailing Address - Phone:402-643-5587
Mailing Address - Fax:
Practice Address - Street 1:802 CUSTER AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-0859
Practice Address - Country:US
Practice Address - Phone:402-371-3567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE17400995633747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant