Provider Demographics
NPI:1891250668
Name:MARKS, ALEXA (NP)
Entity Type:Individual
Prefix:
First Name:ALEXA
Middle Name:
Last Name:MARKS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44819 ATWATER DR # E731
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-5728
Mailing Address - Country:US
Mailing Address - Phone:202-255-6799
Mailing Address - Fax:
Practice Address - Street 1:44679 ENDICOTT DR STE 300
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-5567
Practice Address - Country:US
Practice Address - Phone:804-596-6021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-06
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1037654363LF0000X
WAAP61076883363LF0000X
MDAC003123363LF0000X
FLTPAN395363LF0000X
AZ240885363LF0000X
VA0024177232363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty