Provider Demographics
NPI:1326853458
Name:PRENTICE, ALEXIS JANEAN
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:JANEAN
Last Name:PRENTICE
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 1:1230 EAST DR
Mailing Address - Street 2:
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74006-7803
Mailing Address - Country:US
Mailing Address - Phone:918-534-7105
Mailing Address - Fax:
Practice Address - Street 1:1230 EAST DR
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74006-7803
Practice Address - Country:US
Practice Address - Phone:918-534-7105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator