Individual
ALEXANDRIA WICKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
806 WASENA AVE SW APT 423, ROANOKE, VA 24015-5354
(252) 349-2289
Mailing address
213 S JEFFERSON ST STE 1006, ROANOKE, VA 24011-1713
(540) 224-5352
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110009034
VA
363A00000X
Physician Assistant
—
—
Other
Enumeration date
10/26/2022
Last updated
02/08/2023
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