Basic Information
| Provider Information | |||||||||
| NPI: | 1043431034 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALEXANDER | ||||||||
| FirstName: | EVA | ||||||||
| MiddleName: | MARIE | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 352 E HACKLEY AVENUE | ||||||||
| Address2: | |||||||||
| City: | MUSKEGON HTS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 49444 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2317226062 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 125 E SOUTHERN AVENUE | ||||||||
| Address2: | |||||||||
| City: | MUSKEGON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 494425041 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2317243699 | ||||||||
| FaxNumber: | 2317243659 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0809X | 4704156185 | MI | Y | Nursing Service Providers | Registered Nurse | Psych/Mental Health, Adult |
No ID Information.