Provider Demographics
NPI:1366076481
Name:CARLTON, ALEXANDRA WHITNEY (PA)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:WHITNEY
Last Name:CARLTON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 APPLECROSS RD
Mailing Address - Street 2:
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-8520
Mailing Address - Country:US
Mailing Address - Phone:910-692-8224
Mailing Address - Fax:
Practice Address - Street 1:120 APPLECROSS RD
Practice Address - Street 2:
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-8520
Practice Address - Country:US
Practice Address - Phone:910-692-8224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-27
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-09607363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty