Healthcare Provider Details

I. General information

NPI: 1003604604
Provider Name (Legal Business Name): ALEXANDRA EPERVARY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2025
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 REDBUD LN
WARFORDSBURG PA
17267-8565
US

IV. Provider business mailing address

301 REDBUD LN
WARFORDSBURG PA
17267-8565
US

V. Phone/Fax

Practice location:
  • Phone: 614-460-0438
  • Fax:
Mailing address:
  • Phone: 614-460-0438
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP036258
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: