Individual
ALEXA EVIE NACEANCENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1031 BELLEVUE AVE STE 300, SAINT LOUIS, MO 63117-1857
(314) 647-9444
(314) 647-7317
Mailing address
PO BOX 23340, SAINT LOUIS, MO 63156-3340
(314) 851-1000
(314) 851-4477
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085.007574
IL
363A00000X
Physician Assistant
Primary
2020007934
MO
Other
Enumeration date
02/16/2019
Last updated
07/28/2020
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