Kimberly Jo Alexander, CRNA

Individual provider Active NPI Certified Registered Nurse Anesthetist · Salisbury, NC

NPI 1104858299 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1104858299
Entity type
Individual (NPI type 1)
Primary specialty
Certified Registered Nurse Anesthetist 367500000X
License
43119 (NC)
Practice address
612 Mocksville Ave
Salisbury, NC 28144-2732
Phone
(704) 210-5661
Fax
(704) 210-5660
NPI assigned
Jul 7, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
43119NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Rowan Medical Center LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 43119 NC Yes

Addresses

Primary practice location

612 Mocksville Ave
Salisbury, NC 28144-2732

Mailing address

220 Ferncliff Dr
Salisbury, NC 28147-7211
Phone (704) 636-1420

Other identifiers

IdentifierTypeStateIssuer
8050434MedicaidNC

Other providers in Salisbury, NC

All providers in Salisbury, NC · Certified Registered Nurse Anesthetist in North Carolina

Sources for this page

Verify at the official NPI Registry.