Provider Demographics
NPI:1497386015
Name:BUDD, ALEXANDRA (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:
Last Name:BUDD
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 TARKLIN RD
Mailing Address - Street 2:
Mailing Address - City:SAINT JOHNS
Mailing Address - State:FL
Mailing Address - Zip Code:32259-8770
Mailing Address - Country:US
Mailing Address - Phone:904-402-0901
Mailing Address - Fax:
Practice Address - Street 1:4866 BIG ISLAND DR UNIT 5
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32246-5301
Practice Address - Country:US
Practice Address - Phone:904-652-0652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-01
Last Update Date:2020-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11005004363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner