Provider Demographics
NPI:1932258993
Name:FITZGERALD, ALEXANDRA FISCHELL (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:FISCHELL
Last Name:FITZGERALD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:ALEXANDRA
Other - Middle Name:JILL
Other - Last Name:FISCHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:100 S 10TH ST
Mailing Address - Street 2:SUITE 801
Mailing Address - City:LILLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27546-6690
Mailing Address - Country:US
Mailing Address - Phone:910-893-4111
Mailing Address - Fax:
Practice Address - Street 1:4140 FERNCREEK DR
Practice Address - Street 2:SUITE 801
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-2563
Practice Address - Country:US
Practice Address - Phone:910-484-2171
Practice Address - Fax:910-484-4568
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-00296363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP00282727OtherRAILROAD MEDICARE
Q57303Medicare UPIN
NC2764933Medicare ID - Type Unspecified