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General NPI Number Information
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NPI Number | 1932735206
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Entity Type | Individual
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Provider Name | ALEXANDRA NICOLE HOSKINS CARGO FNP-C
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Gender | Female
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Dates
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Enumeration Date | 03/19/2020
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Last Update Date | 03/19/2020
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Provider Practice Location Address
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Address Line | 720 N LAPEER RD STE 202
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City | LAKE ORION
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State | MI
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Zip | 48362-4011
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Country | US
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Telephone | 248-202-4112
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Fax |
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Provider Business Mailing Address
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Address Line | 5690 CORUNNA AVE
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City | CLARKSTON
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State | MI
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Zip | 48346-3402
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Country | US
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Telephone | 248-202-4112
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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 | 4704321485NSA2005C
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License Number State | MI
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