Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | SP020016 | PA |
NPI | 1023574456 |
---|---|
Provider Name | Alexandra Kirchner |
First Address | Racine, WI 53405-1636 |
Second Address | Philadelphia, PA 19104-4319 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2019 |
Last Update Date | 11/02/2019 |