Basic Information
| Provider Information | |||||||||
| NPI: | 1740564137 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OWENS | ||||||||
| FirstName: | ALEXANDRA | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7510 DELL DR | ||||||||
| Address2: | |||||||||
| City: | NORTH CHESTERFIELD | ||||||||
| State: | VA | ||||||||
| PostalCode: | 232356302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4126516320 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8110 MIDLOTHIAN TPKE | ||||||||
| Address2: | |||||||||
| City: | NORTH CHESTERFIELD | ||||||||
| State: | VA | ||||||||
| PostalCode: | 232355116 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8043208160 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/04/2011 | ||||||||
| LastUpdateDate: | 01/26/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 0110004248 | VA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363A00000X | MA055231 | PA | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.