Provider Demographics
NPI:1013525328
Name:MONCADA, ALEXANDRA FRANCES (RN)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:FRANCES
Last Name:MONCADA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 HEIDI WAY
Mailing Address - Street 2:
Mailing Address - City:SCOTT DEPOT
Mailing Address - State:WV
Mailing Address - Zip Code:25560-9223
Mailing Address - Country:US
Mailing Address - Phone:304-932-7240
Mailing Address - Fax:
Practice Address - Street 1:68 HEIDI WAY
Practice Address - Street 2:
Practice Address - City:SCOTT DEPOT
Practice Address - State:WV
Practice Address - Zip Code:25560-9223
Practice Address - Country:US
Practice Address - Phone:304-932-7240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-22
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV106242163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse