Provider Demographics
NPI:1689394652
Name:SHELDON, ALEXANDRA TAYLOR (CRNP)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:TAYLOR
Last Name:SHELDON
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 1:129 EDGEWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:INDUSTRY
Mailing Address - State:PA
Mailing Address - Zip Code:15052-2115
Mailing Address - Country:US
Mailing Address - Phone:724-561-5701
Mailing Address - Fax:
Practice Address - Street 1:129 EDGEWOOD CIR
Practice Address - Street 2:
Practice Address - City:INDUSTRY
Practice Address - State:PA
Practice Address - Zip Code:15052-2115
Practice Address - Country:US
Practice Address - Phone:724-561-5701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAF08220246207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAF08220246OtherAANP