Provider Demographics
NPI:1730897810
Name:HURLEY, ALEXANDRA LOUISE (NP)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:LOUISE
Last Name:HURLEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20886 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:GRUNDY
Mailing Address - State:VA
Mailing Address - Zip Code:24614-9597
Mailing Address - Country:US
Mailing Address - Phone:276-935-7515
Mailing Address - Fax:276-935-4351
Practice Address - Street 1:20886 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:GRUNDY
Practice Address - State:VA
Practice Address - Zip Code:24614-9597
Practice Address - Country:US
Practice Address - Phone:276-935-7515
Practice Address - Fax:276-935-4351
Is Sole Proprietor?:No
Enumeration Date:2022-11-08
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024185360363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0024185360OtherLICENSE NUMBER- NP