Provider Demographics
NPI:1699664789
Name:ALEXANDER, ANTEA VANESSA (NP)
Entity type:Individual
Prefix:MRS
First Name:ANTEA
Middle Name:VANESSA
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ANTEA
Other - Middle Name:VANESSA
Other - Last Name:DEGRAFFENREID
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:72 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SUTTON
Mailing Address - State:MA
Mailing Address - Zip Code:01590-1608
Mailing Address - Country:US
Mailing Address - Phone:774-214-6884
Mailing Address - Fax:774-214-6884
Practice Address - Street 1:55 LAKE AVE N
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01655-0002
Practice Address - Country:US
Practice Address - Phone:774-441-8081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2321929363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily