Provider Demographics
NPI:1952093635
Name:ALEXANDER, MEGAN KRISTINE (PA-C)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:KRISTINE
Last Name:ALEXANDER
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 1:2108 NICHOLASVILLE RD FL 2
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-2502
Mailing Address - Country:US
Mailing Address - Phone:859-278-9413
Mailing Address - Fax:859-278-9413
Practice Address - Street 1:2108 NICHOLASVILLE RD FL 2
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-2502
Practice Address - Country:US
Practice Address - Phone:859-278-9413
Practice Address - Fax:859-278-9413
Is Sole Proprietor?:No
Enumeration Date:2023-05-22
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPA3253363A00000X, 363AS0400X, 363A00000X, 363AM0700X
KYTC025363AM0700X, 363A00000X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100924890Medicaid