Provider Demographics
NPI:1306388202
Name:MCKINSEY, ALEXANDRA RIEHM (PA)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:RIEHM
Last Name:MCKINSEY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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:704-343-9800
Mailing Address - Fax:704-347-2011
Practice Address - Street 1:125 QUEENS RD STE 200
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-3215
Practice Address - Country:US
Practice Address - Phone:704-343-9800
Practice Address - Fax:704-384-8880
Is Sole Proprietor?:No
Enumeration Date:2016-11-08
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2651363A00000X
NC0010-06761363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant