Provider Demographics
NPI:1689137168
Name:MOORE, ALEJANDRA (CRNP)
Entity Type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:
Last Name:MOORE
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 1:681 S FRONT ST
Mailing Address - Street 2:
Mailing Address - City:STEELTON
Mailing Address - State:PA
Mailing Address - Zip Code:17113-2914
Mailing Address - Country:US
Mailing Address - Phone:717-991-2560
Mailing Address - Fax:
Practice Address - Street 1:366 ALEXANDER SPRING RD STE 2
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17015-9214
Practice Address - Country:US
Practice Address - Phone:717-960-3927
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-10
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP019856363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner