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Individual
MRS. STACY A. ALEXANDER
Active
Individual
MRS. STACY A. ALEXANDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15-00973
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110173325
MEDICARE - VCPG
—
01
—
110999006
MEDICARE - WT MGMT
—
Enumeration date
07/27/2006
Last updated
03/02/2017
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