Individual
ALEXANDRA G THEODOSIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, APNP, FNP-C
Contact information
Practice address
1350 S SUNNY SLOPE RD, BROOKFIELD, WI 53005-7060
(262) 798-8750
Mailing address
3235 S REGAL DR, NEW BERLIN, WI 53151-4453
(630) 337-4326
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
13319-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13319-33
STATE OF WISCONSIN DEPARTMENT OF SAFETY AND PROFESSIONAL SERVICES
WI
Enumeration date
11/18/2022
Last updated
11/18/2022
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