Provider Demographics
NPI:1679581938
Name:LAXTON, ALICE COOK (ARNP)
Entity type:Individual
Prefix:MS
First Name:ALICE
Middle Name:COOK
Last Name:LAXTON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:ALICE
Other - Middle Name:ELIZABETH
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:960 LEARNING WAY
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32306-4178
Mailing Address - Country:US
Mailing Address - Phone:850-644-1802
Mailing Address - Fax:850-644-4251
Practice Address - Street 1:960 LEARNING WAY
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32306-4178
Practice Address - Country:US
Practice Address - Phone:850-644-1802
Practice Address - Fax:850-644-4251
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1522242363LX0001X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology