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NPI Code Detail

MEDICARE: ALEXANDRA SUSAN SHONK APRN, CNP, FNP-BC

MEDICARE: ALEXANDRA SUSAN SHONK APRN, CNP, FNP-BC
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
1363LF0000XFamily Nurse PractitionerAPRN.CNP.0041829OH

General Provider Information

NPI Number : 1255262192
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXANDRA SUSAN SHONK APRN, CNP, FNP-BC
Provider Business Mailing Address
First Line : 1331 N FAIRFIELD RD
Second Line :
City : BEAVERCREEK
State : OH
Zip : 45432-2643
Country : US
Telephone Number : 937-426-4478
Fax Number : 937-426-8070
Provider Business Practice Location Address
First Line : 1331 N FAIRFIELD RD
Second Line :
City : BEAVERCREEK
State : OH
Zip : 45432-2643
Country : US
Telephone Number : 937-426-4478
Fax Number : 937-426-8070
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2026
Last Update Date : 05/28/2026

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