Provider Demographics
NPI:1063109023
Name:AUBREY, ALEXIS LENORE (RN 706523-01)
Entity type:Individual
Prefix:MS
First Name:ALEXIS
Middle Name:LENORE
Last Name:AUBREY
Suffix:
Gender:F
Credentials:RN 706523-01
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 ENFIELD FALLS RD
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-8757
Mailing Address - Country:US
Mailing Address - Phone:607-229-3633
Mailing Address - Fax:
Practice Address - Street 1:130 ENFIELD FALLS RD
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-8757
Practice Address - Country:US
Practice Address - Phone:607-229-3633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-20
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY706523-01163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator