Provider Demographics
NPI:1154019735
Name:WARD, ALEXANDRIA RAIN (FNP)
Entity type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:RAIN
Last Name:WARD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:ALEXANDRIA
Other - Middle Name:RAIN
Other - Last Name:MIDDLETON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5555 SKEENS RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BIG STONE GAP
Mailing Address - State:VA
Mailing Address - Zip Code:24219-4063
Mailing Address - Country:US
Mailing Address - Phone:276-220-3142
Mailing Address - Fax:
Practice Address - Street 1:5555 SKEENS RIDGE RD
Practice Address - Street 2:
Practice Address - City:BIG STONE GAP
Practice Address - State:VA
Practice Address - Zip Code:24219-4063
Practice Address - Country:US
Practice Address - Phone:276-220-3142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001274107163W00000X
VA0024186608363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse