Provider Demographics
NPI:1730909789
Name:ALEXIS, TARAH R
Entity type:Individual
Prefix:MS
First Name:TARAH
Middle Name:R
Last Name:ALEXIS
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 1:100 DRURY LN APT 3A1
Mailing Address - Street 2:
Mailing Address - City:ASBURY PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-5044
Mailing Address - Country:US
Mailing Address - Phone:973-380-8106
Mailing Address - Fax:
Practice Address - Street 1:100 DRURY LN APT 3A1
Practice Address - Street 2:
Practice Address - City:ASBURY PARK
Practice Address - State:NJ
Practice Address - Zip Code:07712-5044
Practice Address - Country:US
Practice Address - Phone:973-380-8106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula