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General NPI Number Information
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NPI Number | 1770266595
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Entity Type | Individual
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Provider Name | ALEXANDRA LEE MACALLE NP
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Gender | Female
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Dates
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Enumeration Date | 08/09/2023
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 5030 GEORGIA BELLE CT # 2036
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City | NORCROSS
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State | GA
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Zip | 30093-2667
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Country | US
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Telephone | 678-209-2745
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Fax |
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Provider Business Mailing Address
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Address Line | 2706 DREW VALLEY RD NE
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City | BROOKHAVEN
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State | GA
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Zip | 30319-3712
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Country | US
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Telephone | 919-452-1994
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 0024187601
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN333898
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License Number State | GA
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