=====================================================
General NPI Number Information
=====================================================
NPI Number | 1215149752
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TERRY ANNE ALEXANDER FNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/04/2007
-----------------------------------------------------
Last Update Date | 09/12/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1756 RTE 9D
-----------------------------------------------------
City | COLD SPRING
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10516
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 845-809-5661
-----------------------------------------------------
Fax | 845-809-5663
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1756 ROUTE 9D FL 2
-----------------------------------------------------
City | COLD SPRING
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10516-2619
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 845-809-5661
-----------------------------------------------------
Fax | 845-809-5663
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 330623
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------