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General NPI Number Information
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NPI Number | 1972517100
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Entity Type | Individual
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Provider Name | STACY A. ALEXANDER PA-C
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Gender | Female
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 03/02/2017
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Provider Practice Location Address
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Address Line | 6100 E CENTRAL AVE STE 3 STE 101
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City | WICHITA
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State | KS
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Zip | 67208-4237
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Country | US
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Telephone | 316-689-5235
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Fax | 316-691-6788
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Provider Business Mailing Address
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Address Line | 405 N BAILEY MAE CT
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City | VALLEY CENTER
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State | KS
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Zip | 67147-4011
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Country | US
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Telephone | 316-744-7924
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Fax | 316-259-1972
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 15-00973
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License Number State | KS
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