Provider Demographics
NPI:1720809098
Name:KOWNURKO, ALEXANDRA RAY (CNM)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:RAY
Last Name:KOWNURKO
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3506 KENNETT PIKE STE 100
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19807-3019
Mailing Address - Country:US
Mailing Address - Phone:302-661-3375
Mailing Address - Fax:302-661-3374
Practice Address - Street 1:3506 KENNETT PIKE STE 100
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19807-3019
Practice Address - Country:US
Practice Address - Phone:302-661-3375
Practice Address - Fax:302-661-3374
Is Sole Proprietor?:No
Enumeration Date:2024-10-21
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PARN699033163W00000X
PAMW010829367A00000X
DELK-0010246367A00000X
DEL1-0053475163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse