Healthcare Provider Details

I. General information

NPI: 1659848455
Provider Name (Legal Business Name): ALEXANDRA GRAL FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2018
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13203 N 103RD AVE STE H5
SUN CITY AZ
85351-3032
US

IV. Provider business mailing address

PO BOX 5068
SUN CITY WEST AZ
85376
US

V. Phone/Fax

Practice location:
  • Phone: 623-777-4747
  • Fax:
Mailing address:
  • Phone: 623-777-4747
  • Fax: 623-777-4748

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2013024109
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number8789-33
License Number StateWI
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number255379
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: