| NPI | 1811488976 |
|---|---|
| Former Name | ALEXA VICTORIA NICKEL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 9127639-4405) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 9127639-3102) |
| Enumeration Date | 2018-05-24 |
| Last Update Date | 2024-01-31 |