Individual provider Active NPI

Alexandra Kirczow, RN

  • Registered Nurse
  • Moab, UT
National Provider Identifier
1235905191
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
12624282-3102 Issued in UT
Practice address
382 W Care Campus Dr
Moab, UT 84532-2331
Phone
(435) 719-5547
Fax
(435) 719-3971
NPI assigned
Nov 30, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 12624282-3102 UT Primary

Addresses

Primary practice location

382 W Care Campus Dr
Moab, UT 84532-2331

Mailing address

382 W Care Campus Dr
Moab, UT 84532-2331
Phone (435) 719-5547

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
12624282-3102UTMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1701302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701302400000",
    "number": "1235905191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "382 W CARE CAMPUS DR",
            "city": "MOAB",
            "state": "UT",
            "postal_code": "845322331",
            "telephone_number": "435-719-5547",
            "fax_number": "435-719-3971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "382 W CARE CAMPUS DR",
            "city": "MOAB",
            "state": "UT",
            "postal_code": "845322331",
            "telephone_number": "435-719-5547",
            "fax_number": "435-719-3971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRCZOW",
        "first_name": "ALEXANDRA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-30",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "UT",
            "license": "12624282-3102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moab, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.