MEDICARE: ALEXANDRA GONZALEZ RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	336450	AZ

General Provider Information

NPI Number	:	1114857562
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRA GONZALEZ RN

Provider Business Mailing Address
First Line	:	7303 W OREGON AVE
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85303-5725
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7303 W OREGON AVE
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85303-5725
Country	:	US
Telephone Number	:	623-225-6602
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/19/2026
Last Update Date	:	05/19/2026

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