=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982354130
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALEXANDRA MARIE ARMSTRONG FNP-BC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/28/2022
-----------------------------------------------------
Last Update Date | 03/28/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 813 CHURCH ST
-----------------------------------------------------
City | SHENANDOAH
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 51601-2301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-613-7549
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 801 MAPLE ST
-----------------------------------------------------
City | TARKIO
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64491-1436
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-613-7549
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | A168124
-----------------------------------------------------
License Number State | IA
-----------------------------------------------------