Basic Information
| Provider Information | |||||||||
| NPI: | 1578081345 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CARIE-KROEGER | ||||||||
| FirstName: | ALEXANDRIA | ||||||||
| MiddleName: | JO | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1510 | ||||||||
| Address2: | |||||||||
| City: | EVANSVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 477061510 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8124506815 | ||||||||
| FaxNumber: | 8123548280 | ||||||||
| Practice Location | |||||||||
| Address1: | 106 W PIKE AVE | ||||||||
| Address2: | |||||||||
| City: | PETERSBURG | ||||||||
| State: | IN | ||||||||
| PostalCode: | 475678750 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8123541052 | ||||||||
| FaxNumber: | 8123548280 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2017 | ||||||||
| LastUpdateDate: | 10/07/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/07/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | 71007510A | IN | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health | 363L00000X | 00000000000000000 | IN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.