Healthcare Provider Details

I. General information

NPI: 1780314476
Provider Name (Legal Business Name): ALEXANDRA GUZIK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2022
Last Update Date: 12/18/2024
Certification Date: 12/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 MEDICAL PARKWAY MEDICAL STAFF SERVICES
ANNAPOLIS MD
21401
US

IV. Provider business mailing address

225 HARBOR DR
SEVERNA PARK MD
21146-1319
US

V. Phone/Fax

Practice location:
  • Phone: 443-481-4150
  • Fax:
Mailing address:
  • Phone: 410-300-6008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License NumberR212408
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number0024184927
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License NumberR212408
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: