Provider Demographics
NPI:1376670687
Name:ALEXANDER, KIRSTEN A (DC)
Entity Type:Individual
Prefix:MRS
First Name:KIRSTEN
Middle Name:A
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:996 SOUTH MAIN ST
Mailing Address - Street 2:UNIT 1B
Mailing Address - City:STOWE
Mailing Address - State:VT
Mailing Address - Zip Code:05672
Mailing Address - Country:US
Mailing Address - Phone:802-253-7411
Mailing Address - Fax:
Practice Address - Street 1:996 SOUTH MAIN ST
Practice Address - Street 2:UNIT 1B
Practice Address - City:STOWE
Practice Address - State:VT
Practice Address - Zip Code:05672
Practice Address - Country:US
Practice Address - Phone:802-253-7411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0060001076111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTOVN2414Medicaid
VTOVN2414Medicaid