Individual
ALEXANDRIA ANN MEDIAVILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
4000 CAMBRIDGE ST, KANSAS CITY, KS 66160-8501
(913) 588-1227
Mailing address
4000 CAMBRIDGE ST STE G600, KANSAS CITY, KS 66160-8501
(913) 588-1227
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
14-137804
KS
163W00000X
Registered Nurse
2016024460
MO
363LF0000X
Family Nurse Practitioner
Primary
53-82688
KS
Other
Enumeration date
10/24/2023
Last updated
11/29/2023
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