MEDICARE: MRS. ALEXANDRA ELISE HASELEY FNP

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	351559	NY
2	363LF0000X	Family Nurse Practitioner	29719	SC

General Provider Information

NPI Number	:	1477257798
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALEXANDRA ELISE HASELEY FNP

Provider Business Mailing Address
First Line	:	PO BOX 751649
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28275-1649
Country	:	US
Telephone Number	:	888-472-0043
Fax Number	:	888-472-0043

Provider Business Practice Location Address
First Line	:	897 VON KOLNITZ RD STE 101
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29464-3630
Country	:	US
Telephone Number	:	843-534-1770
Fax Number	:	877-453-3943

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

Provider Enumeration Date	:	03/29/2023
Last Update Date	:	09/17/2025

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