Healthcare Provider Details

I. General information

NPI: 1922522713
Provider Name (Legal Business Name): ALEXANDRA BLAIR YOWELL AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALEXANDRA BLAIR SHORT

II. Dates (important events)

Enumeration Date: 08/02/2017
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

808 TRITON CT STE 100
NEWPORT NEWS VA
23606-4538
US

IV. Provider business mailing address

808 TRITON COURT SUITE 100
NEWPORT NEWS VA
23606-4520
US

V. Phone/Fax

Practice location:
  • Phone: 757-874-4665
  • Fax: 757-874-1286
Mailing address:
  • Phone: 757-874-4665
  • Fax: 757-874-1286

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number2201001668
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: