Provider Demographics
NPI:1679058432
Name:CHUKES, ALEXANDRIA (MSN, APRN, AGNP-C)
Entity Type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:
Last Name:CHUKES
Suffix:
Gender:F
Credentials:MSN, APRN, AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 616788
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32861-6788
Mailing Address - Country:US
Mailing Address - Phone:407-533-6836
Mailing Address - Fax:407-770-0661
Practice Address - Street 1:2910 EAST FRANKLIN BLVD #1
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28056
Practice Address - Country:US
Practice Address - Phone:704-648-0460
Practice Address - Fax:855-446-7146
Is Sole Proprietor?:No
Enumeration Date:2018-09-27
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704351593363LP2300X
NC5011040363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care