Provider Demographics
NPI:1851905491
Name:BURLEY, ALEXA L (CRNP-PMH)
Entity Type:Individual
Prefix:
First Name:ALEXA
Middle Name:L
Last Name:BURLEY
Suffix:
Gender:F
Credentials:CRNP-PMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4407 PINE TOP ROAD
Mailing Address - Street 2:
Mailing Address - City:TAYLORS ISLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21669
Mailing Address - Country:US
Mailing Address - Phone:410-474-1765
Mailing Address - Fax:
Practice Address - Street 1:300 BYRN ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21613-1908
Practice Address - Country:US
Practice Address - Phone:410-228-5511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-01
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR225890363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health