Gross, Alexandra Shade

Gross, Alexandra Shade is an individual health care provider with primary practice located at 500 Hospital Dr , Wetumpka AL 36092-1625. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Gross, Alexandra Shade can be contacted via phone (334) 567-4311.

Contact Information

Primary practice address
500 Hospital Dr Wetumpka AL 36092-1625
Phone: (334) 567-4311
Fax: (334) 514-3686
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 1-152055 Alabama

Profile Details

NPI number 1356083968
LBN Legal business name Gross, Alexandra Shade
Credentials CRNP
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 13th, 2022
Last updated Dec 29th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356083968 NPPES
Alabama MEDICAID 285542
Alabama Other 04220120
Alabama Other 1-152055

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