Healthcare Provider Details

I. General information

NPI: 1376112854
Provider Name (Legal Business Name): ALIXANDRIA DRUMMOND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2021
Last Update Date: 06/21/2021
Certification Date: 06/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 NORTHSIDE FORSYTH DR STE 240
CUMMING GA
30041-6017
US

IV. Provider business mailing address

3245 COVE CREEK LN
CUMMING GA
30040-5075
US

V. Phone/Fax

Practice location:
  • Phone: 770-844-0877
  • Fax:
Mailing address:
  • Phone: 404-353-6843
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN251944
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: