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NPI Code Detail

MEDICARE: ALEXANDRA KIDDY CRNA

MEDICARE: ALEXANDRA KIDDY CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner0024175771VA
2390200000XStudent in an Organized Health Care Education/Training Program
3367500000XCertified Registered Nurse Anesthetist0024175771VA

General Provider Information

NPI Number : 1467960617
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXANDRA KIDDY CRNA
Provider Business Mailing Address
First Line : 1602 SKIPWITH RD
Second Line :
City : RICHMOND
State : VA
Zip : 23229-5205
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1602 SKIPWITH RD
Second Line :
City : RICHMOND
State : VA
Zip : 23229-5205
Country : US
Telephone Number : 804-289-4937
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/22/2018
Last Update Date : 06/08/2026

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Directions to “ ALEXANDRA KIDDY CRNA” Practice Location

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