Provider Demographics
NPI:1902433824
Name:BEETLER, ALEXANDRIA NICOLE (APRNCNP)
Entity type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:NICOLE
Last Name:BEETLER
Suffix:
Gender:F
Credentials:APRNCNP
Other - Prefix:
Other - First Name:ALEXANDRIA
Other - Middle Name:NICOLE
Other - Last Name:FREESE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 638269
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-8269
Mailing Address - Country:US
Mailing Address - Phone:440-816-4965
Mailing Address - Fax:
Practice Address - Street 1:18181 PEARL RD STE B202
Practice Address - Street 2:
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44136-6951
Practice Address - Country:US
Practice Address - Phone:440-816-4965
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-23
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH.025988363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner