Provider Demographics
NPI:1346901410
Name:PETERSON, ALEXANDRIA N (HOME HEALTHCARE)
Entity Type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:N
Last Name:PETERSON
Suffix:
Gender:F
Credentials:HOME HEALTHCARE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:641 CROSSROADS PARK DR
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29803-9023
Mailing Address - Country:US
Mailing Address - Phone:803-439-2773
Mailing Address - Fax:
Practice Address - Street 1:641 CROSSROADS PARK DR
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29803-9023
Practice Address - Country:US
Practice Address - Phone:803-439-2773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-31
Last Update Date:2021-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health