National Provider Identifier

Alexis Rae Peterson, LPN

Alexis Rae Peterson, LPN is listed in the NPPES registry with a primary specialty of Licensed Practical Nurse in Randolph, NY and a listed phone number of (315) 746-0303.

NPI 1215713185Randolph, NYLicensed Practical Nurse

Profile Overview

NPI
1215713185
Provider Type
Individual
Primary Specialty
Licensed Practical Nurse
Enumeration Date
September 06, 2023
Last Updated
September 06, 2023

Practice Location

  • 356 Main Street Er
  • Randolph, NY 14772-9696

Phone: (315) 746-0303

Specialties

  • Licensed Practical Nurse (164W00000X)
Full Record
NPI
1215713185
Entity Type
Individual
Last Name
Peterson
First Name
Alexis
Middle Name
Rae
Credential
LPN
Mailing Street Address
356 Main Street Er
Mailing City
Randolph
Mailing State
NY
Mailing ZIP Code
14772-9696
Mailing Country
US
Mailing Phone
(315) 746-0303
Practice Street Address
356 Main Street Er
Practice City
Randolph
Practice State
NY
Practice ZIP Code
14772-9696
Practice Country
US
Practice Phone
(315) 746-0303
Enumeration Date
September 06, 2023
Last Updated
September 06, 2023
Sex
Female
Sole Proprietor
No
Certification Date
August 28, 2023
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Licensed Practical Nurse (164W00000X)