Healthcare Provider Details

I. General information

NPI: 1083586465
Provider Name (Legal Business Name): ALEXANDRIA RENEE RITZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2025
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

232 SHARON AVE NW
LENOIR NC
28645-4326
US

IV. Provider business mailing address

PO BOX 5105
BELFAST ME
04915-5100
US

V. Phone/Fax

Practice location:
  • Phone: 828-459-6824
  • Fax: 828-758-7058
Mailing address:
  • Phone: 828-459-6824
  • Fax: 828-758-7058

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-15844
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: