Individual
ALEXANDRIA CROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
653 CLINIC RD, HANNIBAL, MO 63401-3607
(573) 719-3630
(573) 719-3632
Mailing address
118 N 2ND ST STE 200, SAINT CHARLES, MO 63301-2894
(636) 224-1210
(636) 946-0991
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2019030369
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2019030369
LPN LICENSE
MO
Enumeration date
02/18/2020
Last updated
02/18/2020
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