Provider Demographics
NPI:1235643925
Name:ALEXANDER, GWENDOLYN C
Entity Type:Individual
Prefix:
First Name:GWENDOLYN
Middle Name:C
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6338 BENTHAM CT
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-3107
Mailing Address - Country:US
Mailing Address - Phone:240-766-6292
Mailing Address - Fax:
Practice Address - Street 1:6338 BENTHAM CT
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-3107
Practice Address - Country:US
Practice Address - Phone:240-766-6292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-17
Last Update Date:2017-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant