Provider Demographics
NPI:1083476253
Name:WRAY, ALEXIS HOPE (PA)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:HOPE
Last Name:WRAY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1832 ALPINE BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:ALPINE
Mailing Address - State:CA
Mailing Address - Zip Code:91901-2107
Mailing Address - Country:US
Mailing Address - Phone:256-460-9642
Mailing Address - Fax:
Practice Address - Street 1:1832 ALPINE BLVD STE A
Practice Address - Street 2:
Practice Address - City:ALPINE
Practice Address - State:CA
Practice Address - Zip Code:91901-2107
Practice Address - Country:US
Practice Address - Phone:619-722-1072
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant