Provider Demographics
NPI:1932346715
Name:ALEXANDRIA, KARSTEN (ND, LAC)
Entity Type:Individual
Prefix:
First Name:KARSTEN
Middle Name:
Last Name:ALEXANDRIA
Suffix:
Gender:F
Credentials:ND, LAC
Other - Prefix:
Other - First Name:KARSTEN
Other - Middle Name:
Other - Last Name:ALEXANDRIA N.D., P.C.
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1420 E. NORTHERN AVE.
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-4317
Mailing Address - Country:US
Mailing Address - Phone:602-938-8200
Mailing Address - Fax:602-938-8519
Practice Address - Street 1:1420 E. NORTHERN AVE.
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-4317
Practice Address - Country:US
Practice Address - Phone:602-938-8200
Practice Address - Fax:602-938-8519
Is Sole Proprietor?:No
Enumeration Date:2009-01-15
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
0171171100000X
AZ96-473175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist