Provider Demographics
NPI:1932676921
Name:IRENE, ALEXANDRA LEE (NP-C)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:LEE
Last Name:IRENE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:LEE
Other - Last Name:MEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:301 LIPPINCOTT DR STE 410
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4197
Mailing Address - Country:US
Mailing Address - Phone:856-355-0340
Mailing Address - Fax:856-355-0330
Practice Address - Street 1:141 ROUTE 70 E STE B
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053
Practice Address - Country:US
Practice Address - Phone:856-596-9057
Practice Address - Fax:856-596-0837
Is Sole Proprietor?:No
Enumeration Date:2018-10-27
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00878200363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily