Provider Demographics
NPI:1982485249
Name:VIERLING, ALEXANDRIA (PA-C)
Entity Type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:
Last Name:VIERLING
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 1:10600 MONTGOMERY RD STE 300
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:OH
Mailing Address - Zip Code:45242-4464
Mailing Address - Country:US
Mailing Address - Phone:513-853-9250
Mailing Address - Fax:513-281-1908
Practice Address - Street 1:10600 MONTGOMERY RD STE 300
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:OH
Practice Address - Zip Code:45242-4464
Practice Address - Country:US
Practice Address - Phone:513-853-9250
Practice Address - Fax:513-281-1908
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-11
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.008342RX207RG0100X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty