Provider Demographics
NPI:1356150577
Name:THORPE, ALEXIS CHAN (APRN)
Entity type:Individual
Prefix:MR
First Name:ALEXIS
Middle Name:CHAN
Last Name:THORPE
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 SUNRISE AVE
Mailing Address - Street 2:
Mailing Address - City:SATELLITE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32937-3441
Mailing Address - Country:US
Mailing Address - Phone:321-265-1258
Mailing Address - Fax:
Practice Address - Street 1:240 SUNRISE AVE
Practice Address - Street 2:
Practice Address - City:SATELLITE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937-3441
Practice Address - Country:US
Practice Address - Phone:321-265-1258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11038606363LP0808X
FL9251489163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WH0200XNursing Service ProvidersRegistered NurseHome Health