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Individual
ALEXANDRA RENEE MOCK
Active
Individual
ALEXANDRA RENEE MOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
4704362149
MI
363L00000X
Nurse Practitioner
Primary
4704362149
MI
363LP0222X
Critical Care Pediatric Nurse Practitioner
4704362149
MI
Other
Enumeration date
07/01/2024
Last updated
04/08/2025
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