Healthcare Provider Details

I. General information

NPI: 1023534948
Provider Name (Legal Business Name): ALEXA LYNN BARRY MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2017
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3210 N CROATAN HWY STE 1
KILL DEVIL HILLS NC
27948-8516
US

IV. Provider business mailing address

2013 PHOEBUS ST
KILL DEVIL HILLS NC
27948-9367
US

V. Phone/Fax

Practice location:
  • Phone: 704-654-8599
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number08854
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number15481
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: