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General NPI Number Information
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NPI Number | 1902441330
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Entity Type | Individual
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Provider Name | KENYA MARSHALL ALEXANDER LPN
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Gender | Female
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Dates
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Enumeration Date | 11/08/2019
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Last Update Date | 11/08/2019
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Provider Practice Location Address
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Address Line | 7080 CHINCOTEAGUE LN
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City | NEW CHURCH
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State | VA
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Zip | 23415-3838
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Country | US
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Telephone | 757-894-5587
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 49
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City | NEW CHURCH
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State | VA
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Zip | 23415-0049
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Country | US
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Telephone | 757-894-5587
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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 | 364SH0200X
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Taxonomy Name | Home Health Clinical Nurse Specialist
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License Number | LPN083700
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | LPN083700
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License Number State | GA
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