Provider Demographics
NPI:1346045135
Name:GONZALEZ, ALEXA RAE
Entity type:Individual
Prefix:
First Name:ALEXA
Middle Name:RAE
Last Name:GONZALEZ
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 1:819 H ST
Mailing Address - Street 2:
Mailing Address - City:CENTRAL CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68826-1631
Mailing Address - Country:US
Mailing Address - Phone:308-940-3764
Mailing Address - Fax:
Practice Address - Street 1:819 H ST
Practice Address - Street 2:
Practice Address - City:CENTRAL CITY
Practice Address - State:NE
Practice Address - Zip Code:68826-1631
Practice Address - Country:US
Practice Address - Phone:308-940-3764
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-15
Last Update Date:2025-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider