Basic Information
| Provider Information | |||||||||
| NPI: | 1205409067 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PEZZI | ||||||||
| FirstName: | ALEXANDRA | ||||||||
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| Credential: | RN, CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 900 PERSEI PL APT 425 | ||||||||
| Address2: | |||||||||
| City: | NORTH BETHESDA | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208528652 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2153501288 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3300 GALLOWS RD | ||||||||
| Address2: | |||||||||
| City: | FALLS CHURCH | ||||||||
| State: | VA | ||||||||
| PostalCode: | 220423307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7037763138 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/20/2021 | ||||||||
| LastUpdateDate: | 07/20/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/20/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN1038631 | DC | N | Nursing Service Providers | Registered Nurse | 367500000X | 24184424 | VA | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.