Provider Demographics
NPI:1326531807
Name:COLVIN, ALEXANDRA NICOLE (MD)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:NICOLE
Last Name:COLVIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1644 MEDICAL CENTER PT STE 200
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-5765
Mailing Address - Country:US
Mailing Address - Phone:719-634-1994
Mailing Address - Fax:719-634-2906
Practice Address - Street 1:6071 E WOODMEN RD STE 300
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80923-2613
Practice Address - Country:US
Practice Address - Phone:719-531-7007
Practice Address - Fax:719-531-7122
Is Sole Proprietor?:No
Enumeration Date:2018-06-11
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8294208600000X
CODR.0070392208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No208600000XAllopathic & Osteopathic PhysiciansSurgery