Provider Demographics
NPI:1164024618
Name:NELSON, ALEXANDRIA CHARLOTTE
Entity type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:CHARLOTTE
Last Name:NELSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26210 HARPER AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48081-2203
Mailing Address - Country:US
Mailing Address - Phone:888-485-8636
Mailing Address - Fax:
Practice Address - Street 1:26210 HARPER AVE STE 200
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48081-2203
Practice Address - Country:US
Practice Address - Phone:888-485-8638
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-10
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist