Provider Demographics
NPI:1679249957
Name:WEINSTEIN, ALEXANDRA K (FNP-C)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:K
Last Name:WEINSTEIN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 OLD WEST ELM ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:MA
Mailing Address - Zip Code:02359-1731
Mailing Address - Country:US
Mailing Address - Phone:781-924-5980
Mailing Address - Fax:
Practice Address - Street 1:308 KINGSTOWN WAY
Practice Address - Street 2:
Practice Address - City:DUXBURY
Practice Address - State:MA
Practice Address - Zip Code:02332-4647
Practice Address - Country:US
Practice Address - Phone:781-585-5561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-18
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2314741363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily