Provider Demographics
NPI:1285257345
Name:PREDOTA, ALEKSANDRA MARIA (NP)
Entity type:Individual
Prefix:
First Name:ALEKSANDRA
Middle Name:MARIA
Last Name:PREDOTA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:RI
Mailing Address - Zip Code:02871-4427
Mailing Address - Country:US
Mailing Address - Phone:508-364-3278
Mailing Address - Fax:401-356-3323
Practice Address - Street 1:123 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:RI
Practice Address - Zip Code:02871-4427
Practice Address - Country:US
Practice Address - Phone:508-364-3278
Practice Address - Fax:401-356-3323
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-24
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN51144163W00000X
MARN2274173363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse