Provider Demographics
NPI:1265815153
Name:BROTZMAN, ALEXANDRA (FNP-C, PMHNP- BD)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:BROTZMAN
Suffix:
Gender:F
Credentials:FNP-C, PMHNP- BD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4610 PADRE BLVD
Mailing Address - Street 2:
Mailing Address - City:SOUTH PADRE ISLAND
Mailing Address - State:TX
Mailing Address - Zip Code:78597-7327
Mailing Address - Country:US
Mailing Address - Phone:956-299-4706
Mailing Address - Fax:956-761-2643
Practice Address - Street 1:4610 PADRE BLVD
Practice Address - Street 2:
Practice Address - City:SOUTH PADRE ISLAND
Practice Address - State:TX
Practice Address - Zip Code:78597-7327
Practice Address - Country:US
Practice Address - Phone:956-299-4706
Practice Address - Fax:956-761-2643
Is Sole Proprietor?:No
Enumeration Date:2015-07-09
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP128786363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX763336OtherTEXAS BOARD OF NURSING
F0715599OtherAMERICAN ACADEMY OF NURSE PRACTITIONERS