=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013493352
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALEXANDRA MARIE RAMA DNP, FNP-BC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/18/2018
-----------------------------------------------------
Last Update Date | 07/24/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2295 HENRY TECKLENBURG DR
-----------------------------------------------------
City | CHARLESTON
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29414
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 843-722-1985
-----------------------------------------------------
Fax | 843-722-4840
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2295 HENRY TECKLENBURG DR
-----------------------------------------------------
City | CHARLESTON
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29414-7801
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 843-722-1985
-----------------------------------------------------
Fax | 843-722-4840
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | 22060
-----------------------------------------------------
License Number State | SC
-----------------------------------------------------