Provider Demographics
NPI:1821530825
Name:QUINN, ALEXANDRA (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:QUINN
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4735 OGLETOWN STANTON RD STE 3201
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2094
Mailing Address - Country:US
Mailing Address - Phone:302-623-4323
Mailing Address - Fax:302-623-4315
Practice Address - Street 1:4735 OGLETOWN STANTON RD STE 3201
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2094
Practice Address - Country:US
Practice Address - Phone:302-623-4323
Practice Address - Fax:302-623-4315
Is Sole Proprietor?:No
Enumeration Date:2016-11-08
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0047640163W00000X
PASP016601363LA2200X
DELP-0000177363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health