Provider Demographics
NPI:1639633456
Name:CAREY, ALEXANDRA NICHOLE (PA-C)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:NICHOLE
Last Name:CAREY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:NICHOLE
Other - Last Name:SURFACE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
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:
Mailing Address - Fax:
Practice Address - Street 1:1965 S US 29 HWY
Practice Address - Street 2:
Practice Address - City:CHINA GROVE
Practice Address - State:NC
Practice Address - Zip Code:28023-5684
Practice Address - Country:US
Practice Address - Phone:704-855-8338
Practice Address - Fax:704-855-8339
Is Sole Proprietor?:No
Enumeration Date:2019-01-25
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-08809363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant