Provider Demographics
NPI:1851076657
Name:WILEY, ALEXANDRA MAY (PA-C)
Entity Type:Individual
Prefix:MS
First Name:ALEXANDRA
Middle Name:MAY
Last Name:WILEY
Suffix:
Gender:F
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:17284 HIDDEN ESTATES CIR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-5053
Mailing Address - Country:US
Mailing Address - Phone:239-357-7258
Mailing Address - Fax:
Practice Address - Street 1:17284 HIDDEN ESTATES CIR
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-5053
Practice Address - Country:US
Practice Address - Phone:239-357-7258
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-19
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant