Healthcare Provider Details

I. General information

NPI: 1255641098
Provider Name (Legal Business Name): ALEXANDRA V. KUZMAN DNP, APN, PMHNP - BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/14/2010
Last Update Date: 12/19/2022
Certification Date: 12/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

716 EXECUTIVE DR
PRINCETON NJ
08540-1529
US

IV. Provider business mailing address

716 EXECUTIVE DR
PRINCETON NJ
08540-1529
US

V. Phone/Fax

Practice location:
  • Phone: 609-921-9201
  • Fax: 609-921-6850
Mailing address:
  • Phone: 609-921-9201
  • Fax: 609-921-6850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NJ00306700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: