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General NPI Number Information
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NPI Number | 1629801030
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Entity Type | Individual
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Provider Name | ALEXANDRA KHALIL
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Gender | Female
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Dates
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Enumeration Date | 08/21/2024
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Last Update Date | 08/21/2024
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Provider Practice Location Address
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Address Line | 777 MEMORIAL DR SE UNIT 552
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City | ATLANTA
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State | GA
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Zip | 30316-1180
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Country | US
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Telephone | 619-306-5036
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Fax |
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Provider Business Mailing Address
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Address Line | 777 MEMORIAL DR SE UNIT 552
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City | ATLANTA
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State | GA
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Zip | 30316-1180
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Country | US
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Telephone | 619-306-5036
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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 | 146N00000X
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Taxonomy Name | Basic Emergency Medical Technician
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License Number | E181284
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License Number State | CA
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Taxonomy #2
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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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