Provider Demographics
NPI:1083456024
Name:DALTON, ALEXUS K
Entity type:Individual
Prefix:
First Name:ALEXUS
Middle Name:K
Last Name:DALTON
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 1:301 W ACADEMY ST APT 4
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:NC
Mailing Address - Zip Code:27025-2000
Mailing Address - Country:US
Mailing Address - Phone:133-645-3272
Mailing Address - Fax:
Practice Address - Street 1:301 W ACADEMY ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:NC
Practice Address - Zip Code:27025-2044
Practice Address - Country:US
Practice Address - Phone:336-453-2727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-11
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility