MEDICARE: ALEXA WIX PA-C

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	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1669308656
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXA WIX PA-C

Provider Business Mailing Address
First Line	:	105 SE SPRINGDALE DR
Second Line	:
City	:	MOUNT JULIET
State	:	TN
Zip	:	37122-3622
Country	:	US
Telephone Number	:	615-438-2534
Fax Number	:

Provider Business Practice Location Address
First Line	:	105 SE SPRINGDALE DR
Second Line	:
City	:	MOUNT JULIET
State	:	TN
Zip	:	37122-3622
Country	:	US
Telephone Number	:	615-438-2534
Fax Number	:

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

Provider Enumeration Date	:	06/18/2026
Last Update Date	:	06/18/2026

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