Provider Demographics
NPI:1467165852
Name:ALEXANDER, GAYLEN (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:GAYLEN
Middle Name:
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:APRN, FNP-C
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Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:784 HERCULES DR STE 110
Mailing Address - Street 2:
Mailing Address - City:COLCHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05446-8049
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11 BURNHAM AVE
Practice Address - Street 2:
Practice Address - City:RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05701-3205
Practice Address - Country:US
Practice Address - Phone:866-476-1321
Practice Address - Fax:802-775-2044
Is Sole Proprietor?:No
Enumeration Date:2022-12-30
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VT101.0135920363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT6712652Medicaid