Provider Demographics
NPI:1861968133
Name:VITALE, ALEXANDER J (RN)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:J
Last Name:VITALE
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:ALLEN
Other - Middle Name:JESSEE
Other - Last Name:BISHOP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:710 LACY LN
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:MO
Mailing Address - Zip Code:64012-2986
Mailing Address - Country:US
Mailing Address - Phone:816-503-1035
Mailing Address - Fax:
Practice Address - Street 1:710 LACY LN
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:MO
Practice Address - Zip Code:64012-2986
Practice Address - Country:US
Practice Address - Phone:816-503-1035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-15
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN98594163W00000X, 163W00000X
AZ271155163W00000X
MO2017018571163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse