Healthcare Provider Details

I. General information

NPI: 1306737192
Provider Name (Legal Business Name): ALEXANDRA HORNBOGEN DNP-AGNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2025
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 LAKESIDE AVE STE 260
BURLINGTON VT
05401-5911
US

IV. Provider business mailing address

246 RIVER RD
BRISTOL VT
05443-5113
US

V. Phone/Fax

Practice location:
  • Phone: 802-657-7000
  • Fax:
Mailing address:
  • Phone: 231-944-0239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number101.0138031
License Number StateVT
# 2
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number026.0150534
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: