Provider Demographics
NPI:1316221666
Name:ALEXANDER, NANCY K (CNM)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:K
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 E BROWN ST
Mailing Address - Street 2:
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18301-3006
Mailing Address - Country:US
Mailing Address - Phone:570-420-4970
Mailing Address - Fax:570-476-3754
Practice Address - Street 1:3 GLEN COVE DR STE 1
Practice Address - Street 2:
Practice Address - City:ROCKPORT
Practice Address - State:ME
Practice Address - Zip Code:04856
Practice Address - Country:US
Practice Address - Phone:207-301-8900
Practice Address - Fax:207-301-5296
Is Sole Proprietor?:No
Enumeration Date:2011-10-05
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAPRN-CNM367A00000X
WV180367A00000X
PAMW010358367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810025402Medicaid
WVQ42718EMedicare PIN
WVQ42718BMedicare PIN
WVQ42718CMedicare PIN
WVQ42718DMedicare PIN
WV3810025402Medicaid
WVQ42718FMedicare PIN