Healthcare Provider Details

I. General information

NPI: 1528726536
Provider Name (Legal Business Name): SYDNEY N ALEXANDER PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SYDNEY NICOLE ALEXANDER PA

II. Dates (important events)

Enumeration Date: 12/07/2021
Last Update Date: 06/23/2023
Certification Date: 06/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

844 KEMPSVILLE RD STE 204
NORFOLK VA
23502-3927
US

IV. Provider business mailing address

844 KEMPSVILLE RD STE 204
NORFOLK VA
23502-3927
US

V. Phone/Fax

Practice location:
  • Phone: 757-261-0700
  • Fax:
Mailing address:
  • Phone: 757-261-0700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110008708
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: