Provider Demographics
NPI:1548557788
Name:ALEXANDER, SUSAN (CRNP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 OLD YORK ROAD
Mailing Address - Street 2:
Mailing Address - City:JENKINTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19046-0361
Mailing Address - Country:US
Mailing Address - Phone:215-886-1074
Mailing Address - Fax:
Practice Address - Street 1:500 OLD YORK ROAD
Practice Address - Street 2:SUITE 203
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-0361
Practice Address - Country:US
Practice Address - Phone:215-886-0174
Practice Address - Fax:215-886-9217
Is Sole Proprietor?:No
Enumeration Date:2011-07-08
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP011271363L00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine