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Individual

MISS ALEXANDRA DEZELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, MSN, CPNP

Contact information

Practice address
1015 E 32ND ST, STE 203, AUSTIN, TX 78705-2707
(512) 476-5437
Mailing address
1015 E 32ND ST, STE 203, AUSTIN, TX 78705-2707
(512) 476-5437

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
AP126009
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
742809697
TX
Enumeration date
11/20/2014
Last updated
11/20/2014
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