Individual
MISS ALEXA ROUSE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
4930
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6416PA
—
SC
01
—
SCQ9575019
MEDICARE PIN
SC
Enumeration date
02/16/2018
Last updated
10/02/2025
Update your record
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