Healthcare Provider Details

I. General information

NPI: 1932004264
Provider Name (Legal Business Name): ALEXANDRA ANDRAKAKOS MCGAHA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 BREWSTER BLVD
CAMP LEJEUNE NC
28547-2538
US

IV. Provider business mailing address

111 DRAGONFLY LN
HAMPSTEAD NC
28443-1408
US

V. Phone/Fax

Practice location:
  • Phone: 910-450-4503
  • Fax:
Mailing address:
  • Phone: 301-502-2284
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number95041706
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: