Individual
NICOLETTE SUE ALEXANDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1225 E COOLSPRING AVE STE 2E, MICHIGAN CITY, IN 46360-6312
(219) 878-5046
(219) 873-2943
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71002483A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200889540
—
IN
01
—
536057
ANTHEM
IN
Enumeration date
10/04/2007
Last updated
02/10/2023
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