Provider Demographics
NPI:1588377444
Name:BARBOSA, ALEXIS SUZANNE (APRN)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:SUZANNE
Last Name:BARBOSA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 S 77TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-4577
Mailing Address - Country:US
Mailing Address - Phone:402-934-4535
Mailing Address - Fax:
Practice Address - Street 1:140 S 77TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-4577
Practice Address - Country:US
Practice Address - Phone:029-344-5354
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-05
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE114537363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care