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General NPI Number Information
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NPI Number | 1053742197
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Entity Type | Individual
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Provider Name | ALEXANDRA BIRKETT PA-C
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Gender | Female
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Dates
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Enumeration Date | 11/27/2013
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Last Update Date | 01/19/2022
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Provider Practice Location Address
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Address Line | 21585 N 77TH AVE STE 1500
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City | PEORIA
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State | AZ
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Zip | 85382-2138
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Country | US
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Telephone | 623-476-5227
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Fax |
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Provider Business Mailing Address
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Address Line | 7444 W LOS GATOS DR
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City | GLENDALE
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State | AZ
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Zip | 85310-5608
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Country | US
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Telephone | 623-414-2013
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA51377
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 6858
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License Number State | AZ
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