Provider Demographics
NPI:1992253769
Name:ALEXIS, ACELISE ACCEUS (APRN)
Entity type:Individual
Prefix:
First Name:ACELISE
Middle Name:ACCEUS
Last Name:ALEXIS
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 1:6415 LAKE WORTH RD STE 207
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-2904
Mailing Address - Country:US
Mailing Address - Phone:561-328-8420
Mailing Address - Fax:618-282-8845
Practice Address - Street 1:6415 LAKE WORTH RD STE 207
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-2904
Practice Address - Country:US
Practice Address - Phone:561-328-8420
Practice Address - Fax:618-282-8845
Is Sole Proprietor?:No
Enumeration Date:2016-09-21
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9203914363LP0808X
FLARNP9203914363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCKBKBOtherBCBS