Provider Demographics
NPI:1629616552
Name:KITCHENER, ALEXANDRA (APRN)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:KITCHENER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1620 TAMIAMI TRAIL
Mailing Address - Street 2:SUITE 308
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33948-4017
Mailing Address - Country:US
Mailing Address - Phone:941-246-2482
Mailing Address - Fax:941-979-9074
Practice Address - Street 1:1620 TAMIAMI TRAIL
Practice Address - Street 2:SUITE 308
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33948-4017
Practice Address - Country:US
Practice Address - Phone:941-246-2482
Practice Address - Fax:941-979-9074
Is Sole Proprietor?:No
Enumeration Date:2019-12-10
Last Update Date:2025-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11003723363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner