Healthcare Provider Details

I. General information

NPI: 1497146922
Provider Name (Legal Business Name): ALEXANDRA NATIVI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ALEXANDRA LOWRIE

II. Dates (important events)

Enumeration Date: 02/05/2015
Last Update Date: 02/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6600 SPRINGFIELD MALL
SPRINGFIELD VA
22150-1712
US

IV. Provider business mailing address

6718 RUSKIN ST
SPRINGFIELD VA
22150-2039
US

V. Phone/Fax

Practice location:
  • Phone: 703-921-9003
  • Fax: 571-388-5217
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number0230019491
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: