Individual
MRS. ALEXIS ANNE ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
300 PASTEUR DR, STANFORD, CA 94305-2200
(650) 723-4000
Mailing address
300 PASTEUR DR, STANFORD, CA 94305-2200
(650) 723-4000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95011181
CA
363LF0000X
Family Nurse Practitioner
53-76239-012
KS
Other
Enumeration date
02/27/2014
Last updated
02/05/2020
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