Provider Demographics
NPI:1023898129
Name:BLEASDELL, ALEXANDRA KNUDSON (FNP-C)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:KNUDSON
Last Name:BLEASDELL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:ANNE
Other - Last Name:KNUDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:909 SALLY LUNN WAY
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-3030
Mailing Address - Country:US
Mailing Address - Phone:832-748-7298
Mailing Address - Fax:
Practice Address - Street 1:359 VILLAGE COMMONS BLVD
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78633-3007
Practice Address - Country:US
Practice Address - Phone:512-819-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-05
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1126290363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily