Provider Demographics
NPI:1851980676
Name:FITZPATRICK, ALEXANDRA MARY (PA-C)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:MARY
Last Name:FITZPATRICK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:950 HOUSTON NORTHCUTT BLVD STE 205
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-5645
Mailing Address - Country:US
Mailing Address - Phone:843-818-3800
Mailing Address - Fax:888-491-9486
Practice Address - Street 1:950 HOUSTON NORTHCUTT BLVD STE 205
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-5645
Practice Address - Country:US
Practice Address - Phone:843-818-3800
Practice Address - Fax:888-491-9486
Is Sole Proprietor?:No
Enumeration Date:2021-01-15
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC3854363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant