Provider Demographics
NPI:1437494283
Name:BOYLE, ALEXANDRA BROTON (MSN, FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:ALEXANDRA
Middle Name:BROTON
Last Name:BOYLE
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:MS
Other - First Name:ALEXANDRA
Other - Middle Name:BROTON
Other - Last Name:ROWELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:88 WESTMINSTER AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02474-2709
Mailing Address - Country:US
Mailing Address - Phone:617-733-8507
Mailing Address - Fax:617-733-8507
Practice Address - Street 1:49 HARRY KEMP WAY
Practice Address - Street 2:
Practice Address - City:PROVINCETOWN
Practice Address - State:MA
Practice Address - Zip Code:02657-1618
Practice Address - Country:US
Practice Address - Phone:508-487-9395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-05
Last Update Date:2018-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY630464-1163W00000X
MARN2275700163W00000X, 363LF0000X
NYF337154-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse