Basic Information
| Provider Information | |||||||||
| NPI: | 1205419009 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KREBS | ||||||||
| FirstName: | ALEXA | ||||||||
| MiddleName: | JOYCE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 125 EXECUTIVE DR STE H | ||||||||
| Address2: | |||||||||
| City: | DANVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 245414155 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4347911345 | ||||||||
| FaxNumber: | 4347736811 | ||||||||
| Practice Location | |||||||||
| Address1: | 125 EXECUTIVE DR STE H | ||||||||
| Address2: | |||||||||
| City: | DANVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 245414155 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4347911345 | ||||||||
| FaxNumber: | 4347736811 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/30/2021 | ||||||||
| LastUpdateDate: | 06/25/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/25/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 0116035607 | VA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.