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General NPI Number Information
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NPI Number | 1073919197
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Entity Type | Individual
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Provider Name | ALEXANDRA JEAN BACHE PA
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Gender | Female
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Dates
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Enumeration Date | 11/17/2014
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Last Update Date | 08/25/2021
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Provider Practice Location Address
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Address Line | 44035 RIVERSIDE PKWY STE 400
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City | LEESBURG
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State | VA
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Zip | 20176-8260
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Country | US
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Telephone | 703-858-5421
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Fax | 703-858-9573
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Provider Business Mailing Address
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Address Line | 2901 TELESTAR CT STE 300
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City | FALLS CHURCH
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State | VA
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Zip | 22042-1263
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Country | US
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Telephone | 703-591-1688
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Fax | 703-591-1445
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | C0005621
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License Number State | MD
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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 | 0110006143
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License Number State | VA
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