Healthcare Provider Details

I. General information

NPI: 1316676976
Provider Name (Legal Business Name): THECLA ALEXANDER FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2022
Last Update Date: 01/24/2025
Certification Date: 01/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

799 ROCKVILLE PIKE
ROCKVILLE MD
20852-1136
US

IV. Provider business mailing address

799 ROCKVILLE PIKE
ROCKVILLE MD
20852-1136
US

V. Phone/Fax

Practice location:
  • Phone: 301-340-2683
  • Fax:
Mailing address:
  • Phone: 301-340-2683
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number179482
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: