Healthcare Provider Details
I. General information
NPI: 1912748708
Provider Name (Legal Business Name): ALEXANDRA RACHEL INMAN CSA, CSFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/04/2024
Last Update Date: 06/04/2024
Certification Date: 06/04/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
736 BATTLEFIELD BLVD N
CHESAPEAKE VA
23320-4941
US
IV. Provider business mailing address
520 LAKE CREST DR
CHESAPEAKE VA
23323-3818
US
V. Phone/Fax
- Phone: 757-312-8121
- Fax:
- Phone: 757-675-2241
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 246ZC0007X |
| Taxonomy | Surgical Assistant |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: