Provider Demographics
NPI:1598526592
Name:CROSS, ALEXANDRA (RDN)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:CROSS
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:
Other - Last Name:BATTAGLIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN
Mailing Address - Street 1:10915 WELSH HILL ROAD
Mailing Address - Street 2:
Mailing Address - City:FROSTBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21532-2349
Mailing Address - Country:US
Mailing Address - Phone:814-380-3379
Mailing Address - Fax:
Practice Address - Street 1:10915 WELSH HILL ROAD
Practice Address - Street 2:
Practice Address - City:FROSTBURG
Practice Address - State:MD
Practice Address - Zip Code:21532-2349
Practice Address - Country:US
Practice Address - Phone:814-380-3379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-17
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133V00000X
IL164010362133V00000X
MDDX5867133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered