Provider Demographics
NPI:1851918320
Name:ROGERSON, ALEXANDRA BLAISE
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:BLAISE
Last Name:ROGERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 S GEORGE MASON DR STE 107
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-1676
Mailing Address - Country:US
Mailing Address - Phone:703-717-7311
Mailing Address - Fax:703-717-7312
Practice Address - Street 1:950 S GEORGE MASON DR STE 107
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-1676
Practice Address - Country:US
Practice Address - Phone:703-717-7311
Practice Address - Fax:703-717-7312
Is Sole Proprietor?:No
Enumeration Date:2020-07-01
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001249134163W00000X
VA0024179643363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse