Provider Demographics
NPI:1477257798
Name:HASELEY, ALEXANDRA ELISE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:ELISE
Last Name:HASELEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6113 BAER RD
Mailing Address - Street 2:
Mailing Address - City:SANBORN
Mailing Address - State:NY
Mailing Address - Zip Code:14132-9264
Mailing Address - Country:US
Mailing Address - Phone:716-417-5128
Mailing Address - Fax:
Practice Address - Street 1:6113 BAER RD
Practice Address - Street 2:
Practice Address - City:SANBORN
Practice Address - State:NY
Practice Address - Zip Code:14132-9264
Practice Address - Country:US
Practice Address - Phone:716-417-5128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY351559363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily