Healthcare Provider Details

I. General information

NPI: 1174225551
Provider Name (Legal Business Name): ALEXANDRA MARIE CARO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 03/20/2023
Certification Date: 03/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11209 BROOKWOOD AVE
LEAWOOD KS
66211-3097
US

IV. Provider business mailing address

11209 BROOKWOOD AVE
LEAWOOD KS
66211-3097
US

V. Phone/Fax

Practice location:
  • Phone: 913-707-7558
  • Fax:
Mailing address:
  • Phone: 913-707-7558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number13150397082
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: