| NPI | 1164195962 |
|---|---|
| Former Name | ALEXANDRA FAY LONGNECKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704314139) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MI 4704314139) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MI 4704314139) | |
| Enumeration Date | 2021-07-28 |
| Last Update Date | 2023-01-13 |