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General NPI Number Information
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NPI Number | 1225897077
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Entity Type | Individual
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Provider Name | ALEXANDRA LYNN MCMILLEN FNP-C
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Gender | Female
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Dates
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Enumeration Date | 03/14/2024
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Last Update Date | 03/14/2024
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Provider Practice Location Address
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Address Line | 11958 W BROAD ST
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City | HENRICO
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State | VA
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Zip | 23233-1007
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Country | US
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Telephone | 804-360-4669
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Fax |
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Provider Business Mailing Address
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Address Line | 2152 THOROUGHBRED PKWY
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City | GOOCHLAND
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State | VA
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Zip | 23063-3248
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Country | US
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Telephone | 703-338-1678
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 0001282132
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License Number State | VA
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