Provider Demographics
NPI:1407357429
Name:EVERITT, ALEXANDRA L (CRNA)
Entity Type:Individual
Prefix:MS
First Name:ALEXANDRA
Middle Name:L
Last Name:EVERITT
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4455 S PADRE ISLAND DR
Mailing Address - Street 2:STE 11
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-5163
Mailing Address - Country:US
Mailing Address - Phone:361-888-6211
Mailing Address - Fax:361-882-4891
Practice Address - Street 1:6130 PARKWAY DR
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-2455
Practice Address - Country:US
Practice Address - Phone:361-853-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-25
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX815604367H00000X
TX119794367H00000X
TXAP137196367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX815604OtherRN