Provider Demographics
NPI:1811953219
Name:HANKS, ALEXANDRA DEEMER (RN)
Entity type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:DEEMER
Last Name:HANKS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 457
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-8907
Mailing Address - Country:US
Mailing Address - Phone:410-763-9550
Mailing Address - Fax:410-763-9551
Practice Address - Street 1:120 S AURORA ST
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-3515
Practice Address - Country:US
Practice Address - Phone:410-763-9550
Practice Address - Fax:410-763-9551
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-25
Last Update Date:2010-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR050105101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health