Provider Demographics
NPI:1699518555
Name:DESALVO, ALEXIS RENEE (PA)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:RENEE
Last Name:DESALVO
Suffix:
Gender:F
Credentials:PA
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Other - Credentials:
Mailing Address - Street 1:576 LAKESHORE PKWY
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70124-2632
Mailing Address - Country:US
Mailing Address - Phone:504-982-4818
Mailing Address - Fax:
Practice Address - Street 1:3645 HOUMA BLVD
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-4229
Practice Address - Country:US
Practice Address - Phone:504-885-4677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant