Individual
MS. ALEXIS JACQUELINE VOGL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
19465 DEERFIELD AVE, SUITE 408, LANSDOWNE, VA 20176-1701
(703) 723-6568
Mailing address
43191 THISTLEDOWN TER, APT 430, BROADLANDS, VA 20148-4080
(703) 867-9561
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0110002683
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MC10194
MEDICARE INDIVIDUAL PTAN
—
Enumeration date
03/18/2008
Last updated
01/10/2009
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