Provider Demographics
NPI:1760109482
Name:KIRKPATRICK, ALEXANDRIA LOIS (A-GNP-C)
Entity Type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:LOIS
Last Name:KIRKPATRICK
Suffix:
Gender:F
Credentials:A-GNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 W STATE ROUTE 89A STE B
Mailing Address - Street 2:
Mailing Address - City:SEDONA
Mailing Address - State:AZ
Mailing Address - Zip Code:86336-4937
Mailing Address - Country:US
Mailing Address - Phone:928-204-4180
Mailing Address - Fax:928-204-4181
Practice Address - Street 1:3700 W STATE ROUTE 89A
Practice Address - Street 2:
Practice Address - City:SEDONA
Practice Address - State:AZ
Practice Address - Zip Code:86336-4937
Practice Address - Country:US
Practice Address - Phone:928-204-4950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-24
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ268256363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner