Provider Demographics
NPI:1346285822
Name:BOVEY, ALEXANDRA K (CNM)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:K
Last Name:BOVEY
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 1:530 WASHINGTON HWY
Mailing Address - Street 2:SUITE 8
Mailing Address - City:MORRISVILLE
Mailing Address - State:VT
Mailing Address - Zip Code:05661-8715
Mailing Address - Country:US
Mailing Address - Phone:802-888-8100
Mailing Address - Fax:802-888-9438
Practice Address - Street 1:528 WASHINGTON HWY
Practice Address - Street 2:SUITE 8
Practice Address - City:MORRISVILLE
Practice Address - State:VT
Practice Address - Zip Code:05661-8973
Practice Address - Country:US
Practice Address - Phone:802-888-8338
Practice Address - Fax:802-888-8203
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT1010028641367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1012688Medicaid