Provider Demographics
NPI:1053034033
Name:ALFKE, ALIXANDRA NICOLE (RN BSN)
Entity type:Individual
Prefix:
First Name:ALIXANDRA
Middle Name:NICOLE
Last Name:ALFKE
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64236 SECOND AVENUE
Mailing Address - Street 2:
Mailing Address - City:HAPPY CAMP
Mailing Address - State:CA
Mailing Address - Zip Code:96039
Mailing Address - Country:US
Mailing Address - Phone:530-493-5257
Mailing Address - Fax:530-493-5270
Practice Address - Street 1:64236 SECOND AVENUE
Practice Address - Street 2:
Practice Address - City:HAPPY CAMP
Practice Address - State:CA
Practice Address - Zip Code:96039
Practice Address - Country:US
Practice Address - Phone:530-493-5257
Practice Address - Fax:530-493-5270
Is Sole Proprietor?:No
Enumeration Date:2022-09-23
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95164185163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse