Individual provider · Type 1 NPI

Alexis Dianne Pedersen, PA C

Medical Physician Assistant · Phoenix, AZ

NPI number 1306425970 Active

Practice location

2902 W Agua Fria Fwy Ste 1000
Phoenix, AZ 85027-3969

Call (623) 582-6420 Map

Fax (623) 582-6720

Mailing address

10200 Grand Central Ave Ste 220
Owings Mills, MD 21117-4366

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X8682 (AZ)
Student in an Organized Health Care Education/Training Program 390200000XNone listed

Medical Physician Assistant: Definition to come...

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About NPI 1306425970

Alexis Dianne Pedersen, PA C's National Provider Identifier is 1306425970, issued on Apr 2, 2021. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Phoenix, AZ. The record was last updated on Mar 21, 2025.