1811707326 NPI number — MS. MYZA RAE CABOVERDE ALEXANDER RN

Table of content: MS. MYZA RAE CABOVERDE ALEXANDER RN (NPI 1811707326)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811707326 NPI number — MS. MYZA RAE CABOVERDE ALEXANDER RN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALEXANDER
Provider First Name:
MYZA RAE
Provider Middle Name:
CABOVERDE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
RN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ALEXANDER
Provider Other First Name:
MYZA RAE
Provider Other Middle Name:
CANON
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1811707326
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/08/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8701 BROADWAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MERRILLVILLE
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46410-7035
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
219-738-5510
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1248 35TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MUNSTER
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46321-2533
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
219-501-1502
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/08/2025

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207PE0004X , with the licence number:  28254136A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com