MEDICARE: ALEXANDRIA FITCH MS, RD, LDN

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	133V00000X	Registered Dietitian	86022100	NC

General Provider Information

NPI Number	:	1639026156
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRIA FITCH MS, RD, LDN

Provider Business Mailing Address
First Line	:	221 HIDDEN LAKES RD
Second Line	:
City	:	STATESVILLE
State	:	NC
Zip	:	28677-8741
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	19460 OLD JETTON RD STE 203
Second Line	:
City	:	CORNELIUS
State	:	NC
Zip	:	28031-6763
Country	:	US
Telephone Number	:	704-892-4545
Fax Number	:

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

Provider Enumeration Date	:	03/13/2026
Last Update Date	:	03/13/2026

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