1568054963 NPI number — ALEXANDRIA LESLIE SWICEGOOD

Table of content: MS. ANDREA JANE SILVOLA APRN, CRNA (NPI 1942633227)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568054963 NPI number — ALEXANDRIA LESLIE SWICEGOOD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SWICEGOOD
Provider First Name:
ALEXANDRIA
Provider Middle Name:
LESLIE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FOLGER
Provider Other First Name:
ALEXANDRIA
Provider Other Middle Name:
LESLIE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1568054963
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/07/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
401 W AVENUE E APT B
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COPPERAS COVE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76522-2174
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
254-247-5441
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3715 S 1ST ST APT 464
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AUSTIN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78704-0109
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
254-247-5441
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/07/2021

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: RBT-21-154829 . This is a "REGISTERED BEHAVIOR TECHNICHIAN" identifier . This identifiers is of the category "OTHER".