Individual
ALEXANDRA NICOLE DIBASILIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
315 POPE AVE APT 8, FORT LEAVENWORTH, KS 66027-1383
(410) 960-5206
Mailing address
315 POPE AVE APT 8, FORT LEAVENWORTH, KS 66027-1383
(410) 960-5206
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
R249243
MD
Other
Enumeration date
07/06/2022
Last updated
07/06/2022
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