Provider Demographics
NPI:1194168724
Name:MERCHANT, ALEXA JUDITH (NP)
Entity type:Individual
Prefix:
First Name:ALEXA
Middle Name:JUDITH
Last Name:MERCHANT
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3502 HENDERSON BLVD STE 314
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-4087
Mailing Address - Country:US
Mailing Address - Phone:813-714-7397
Mailing Address - Fax:813-462-2921
Practice Address - Street 1:3502 HENDERSON BLVD STE 314
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-4087
Practice Address - Country:US
Practice Address - Phone:813-714-7397
Practice Address - Fax:813-462-2921
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-13
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9432788163W00000X, 363LA2200X, 363LG0600X, 363LP0808X
CA740199163W00000X
CA23657363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology