Provider Demographics
NPI:1881464626
Name:GASKEY, ALEXANNDRA RENE (FNP)
Entity type:Individual
Prefix:
First Name:ALEXANNDRA
Middle Name:RENE
Last Name:GASKEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:ALEX
Other - Middle Name:
Other - Last Name:GASKEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1049 EDGEWATER ST NW # 150
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97304-4046
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1049 EDGEWATER ST NW # 150
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97304-4046
Practice Address - Country:US
Practice Address - Phone:503-814-3343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-03
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10020364363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily