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General NPI Number Information
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NPI Number | 1609441096
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Entity Type | Individual
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Provider Name | ALEXANDRA MARTIN MSN, CRNP
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Gender | Female
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Dates
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Enumeration Date | 05/26/2021
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Last Update Date | 06/12/2023
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Provider Practice Location Address
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Address Line | 1 MEDICAL CENTER DR
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City | LEBANON
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State | NH
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Zip | 03756-0001
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Country | US
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Telephone | 603-650-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 250 W LANCASTER AVE STE 220
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City | PAOLI
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State | PA
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Zip | 19301-1751
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | SP023139
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 091190-23
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License Number State | NH
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