Provider Demographics
NPI:1992336150
Name:DENNY THORNTON, ALEXIS RENEE
Entity type:Individual
Prefix:MRS
First Name:ALEXIS
Middle Name:RENEE
Last Name:DENNY THORNTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALEXIS
Other - Middle Name:RENEE
Other - Last Name:DENNY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5144 GREENHURST DR
Mailing Address - Street 2:
Mailing Address - City:MAPLE HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44137-1126
Mailing Address - Country:US
Mailing Address - Phone:305-330-0215
Mailing Address - Fax:
Practice Address - Street 1:5144 GREENHURST DR
Practice Address - Street 2:
Practice Address - City:MAPLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44137-1126
Practice Address - Country:US
Practice Address - Phone:305-330-0215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-27
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3747P1801X, 175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0445024Medicaid