Provider Demographics
NPI:1477862258
Name:DIGGINS, ALEXANDRIA (LPN)
Entity Type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:
Last Name:DIGGINS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 SOUTH 107TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85323-3309
Mailing Address - Country:US
Mailing Address - Phone:623-478-6300
Mailing Address - Fax:623-478-6320
Practice Address - Street 1:1600 SOUTH 107TH AVENUE
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85323-3309
Practice Address - Country:US
Practice Address - Phone:623-478-6300
Practice Address - Fax:623-478-6320
Is Sole Proprietor?:No
Enumeration Date:2010-09-28
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLP046460390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program