Provider Demographics
NPI:1578023214
Name:MAKSIMOWSKI, ALEXANDRA BLUM (CRNP)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:BLUM
Last Name:MAKSIMOWSKI
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:PO BOX 2895
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35056-2895
Mailing Address - Country:US
Mailing Address - Phone:256-737-2682
Mailing Address - Fax:256-737-2152
Practice Address - Street 1:1912 AL HIGHWAY 157
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35058-0609
Practice Address - Country:US
Practice Address - Phone:256-737-2682
Practice Address - Fax:256-737-2152
Is Sole Proprietor?:No
Enumeration Date:2019-03-20
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-143525363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care