Provider Demographics
NPI:1902514235
Name:LEPECHA, ALEXANDRA M
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:M
Last Name:LEPECHA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20745 WILLIAMSPORT PL STE 100
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-6518
Mailing Address - Country:US
Mailing Address - Phone:703-215-9152
Mailing Address - Fax:
Practice Address - Street 1:20745 WILLIAMSPORT PL STE 100
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-6518
Practice Address - Country:US
Practice Address - Phone:703-215-9152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-07
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133V00000X
VA0110-009059363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered