Shakora Alexander

Individual provider Active NPI Driver · Brodnax, VA

NPI 1194249300 · NPPES record last updated Jul 29, 2017

Key facts

NPI
1194249300
Entity type
Individual (NPI type 1)
Primary specialty
Driver 172A00000X
Practice address
11738 Robinson Ferry Rd
Brodnax, VA 23920-3203
Phone
(804) 929-1906
NPI assigned
Jul 29, 2017
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X Yes

Addresses

Primary practice location

11738 Robinson Ferry Rd
Brodnax, VA 23920-3203

Mailing address

11738 Robinson Ferry Rd
Brodnax, VA 23920-3203
Phone (804) 929-1906

Other providers in Brodnax, VA

All providers in Brodnax, VA · Driver in Virginia

Sources for this page

Verify at the official NPI Registry.