Individual
ALEXIS RAE STAFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12557 RAVENWOOD DR, CHARDON, OH 44024-9009
(440) 285-3568
(440) 285-4552
Mailing address
1751 BLASE NEMETH RD, PAINESVILLE, OH 44077-4897
(440) 343-8718
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.456353
OH
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN.CNP.0031863
OH
Other
Enumeration date
01/17/2022
Last updated
11/19/2024
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