Provider Demographics
NPI:1154019735
Name:WARD, ALEXANDRIA RAIN (NP)
Entity type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:RAIN
Last Name:WARD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ALEXANDRIA
Other - Middle Name:RAIN
Other - Last Name:MIDDLETON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5555 SKEENS RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BIG STONE GAP
Mailing Address - State:VA
Mailing Address - Zip Code:24219-4063
Mailing Address - Country:US
Mailing Address - Phone:276-220-3142
Mailing Address - Fax:
Practice Address - Street 1:1725 PARK AVE SW
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:VA
Practice Address - Zip Code:24273-1608
Practice Address - Country:US
Practice Address - Phone:276-409-5922
Practice Address - Fax:276-409-5923
Is Sole Proprietor?:No
Enumeration Date:2023-05-01
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001274107163W00000X
VA0024186608363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0001274107OtherSTATE LICENSE
VA1154019735Medicaid
VA0024186608OtherSTATE LICENSE