Provider Demographics
NPI:1063179398
Name:MEIXSELL, ALEXIS KRISTINE
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:KRISTINE
Last Name:MEIXSELL
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 1:7721 TOWNSHIP LINE RD
Mailing Address - Street 2:
Mailing Address - City:NAZARETH
Mailing Address - State:PA
Mailing Address - Zip Code:18064-9749
Mailing Address - Country:US
Mailing Address - Phone:484-714-5921
Mailing Address - Fax:
Practice Address - Street 1:7721 TOWNSHIP LINE RD
Practice Address - Street 2:
Practice Address - City:NAZARETH
Practice Address - State:PA
Practice Address - Zip Code:18064-9749
Practice Address - Country:US
Practice Address - Phone:484-714-5921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-22
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer