Provider Demographics
NPI:1952643033
Name:PARKER, ALEXANDRIA LEE (PTA)
Entity Type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:LEE
Last Name:PARKER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5304 GRANADA HILLS DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-8579
Mailing Address - Country:US
Mailing Address - Phone:303-476-0721
Mailing Address - Fax:
Practice Address - Street 1:300 MEADOWLANDS DR
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NC
Practice Address - Zip Code:27278-8502
Practice Address - Country:US
Practice Address - Phone:919-644-6714
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-26
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO225200000X
TX225200000X
NCA7522225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCA7522OtherNC PTA LICENSE