Healthcare Provider Details

I. General information

NPI: 1720769581
Provider Name (Legal Business Name): ALESANDRA PAVLIK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2023
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 FAYETTEVILLE ST STE 1100
RALEIGH NC
27601-3000
US

IV. Provider business mailing address

421 FAYETTEVILLE ST STE 1100
RALEIGH NC
27601-3000
US

V. Phone/Fax

Practice location:
  • Phone: 888-731-8994
  • Fax:
Mailing address:
  • Phone: 888-731-8994
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number898
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number5021331
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: