MEDICARE: ALEXANDRA FAYE MATSIS NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	5020794	NC
2	163WP2201X	Ambulatory Care Registered Nurse	RN2353364	MA

General Provider Information

NPI Number	:	1285475921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRA FAYE MATSIS NP

Provider Business Mailing Address
First Line	:	128 JENNISON RD
Second Line	:
City	:	MILFORD
State	:	NH
Zip	:	03055-4260
Country	:	US
Telephone Number	:	603-801-8870
Fax Number	:

Provider Business Practice Location Address
First Line	:	202 JEFFERSON ST
Second Line	:
City	:	SANFORD
State	:	NC
Zip	:	27330-5636
Country	:	US
Telephone Number	:	919-842-5190
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2024
Last Update Date	:	09/30/2025

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