Provider Demographics
NPI:1134783764
Name:SPRANKLE, ALEXIS MCKENNA (PA-C)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:MCKENNA
Last Name:SPRANKLE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:903 NORTHEAST DR STE 301
Mailing Address - Street 2:
Mailing Address - City:DAVIDSON
Mailing Address - State:NC
Mailing Address - Zip Code:28036-7438
Mailing Address - Country:US
Mailing Address - Phone:704-894-9309
Mailing Address - Fax:
Practice Address - Street 1:903 NORTHEAST DR STE 301
Practice Address - Street 2:
Practice Address - City:DAVIDSON
Practice Address - State:NC
Practice Address - Zip Code:28036-7438
Practice Address - Country:US
Practice Address - Phone:704-894-9309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-29
Last Update Date:2022-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC363A00000X363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant