Provider Demographics
NPI:1013554153
Name:CARONIS, ALEXANDRA CHARLOTTE (PA)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:CHARLOTTE
Last Name:CARONIS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:CHARLOTTE
Other - Last Name:SCHULER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1901 BRUNSWICK AVE STE 200
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-1897
Practice Address - Country:US
Practice Address - Phone:704-316-5025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-09
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
NC0010-09725363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant