Provider Demographics
NPI:1619846375
Name:HERNANDEZ GERENA, LEXLY ANN
Entity type:Individual
Prefix:
First Name:LEXLY
Middle Name:ANN
Last Name:HERNANDEZ GERENA
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 1:211 WHISPER KNOLL CIR UNIT B
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504-4840
Mailing Address - Country:US
Mailing Address - Phone:907-342-9109
Mailing Address - Fax:
Practice Address - Street 1:2602 FAIRBANKS ST
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-2824
Practice Address - Country:US
Practice Address - Phone:907-646-2225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-31
Last Update Date:2025-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK244538225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist