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General NPI Number Information
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NPI Number | 1164983029
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Entity Type | Individual
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Provider Name | ALEX CHRISTOPHER WILKIE DNAP, CRNA
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Gender | Male
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Dates
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Enumeration Date | 03/25/2019
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Last Update Date | 11/24/2020
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Provider Practice Location Address
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Address Line | 4445 MAGNOLIA AVE
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City | RIVERSIDE
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State | CA
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Zip | 92501-4199
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Country | US
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Telephone | 402-321-7754
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Fax |
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Provider Business Mailing Address
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Address Line | 807 S COWLEY ST APT 27
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City | SPOKANE
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State | WA
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Zip | 99202-1278
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Country | US
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Telephone | 402-321-7754
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | NA95001378
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License Number State | CA
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