1265409833 NPI number — ERICA ANNICE ALESSANDRINI CRNP

Table of content: ERICA ANNICE ALESSANDRINI CRNP (NPI 1265409833)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265409833 NPI number — ERICA ANNICE ALESSANDRINI CRNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALESSANDRINI
Provider First Name:
ERICA
Provider Middle Name:
ANNICE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CRNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BRIGSON
Provider Other First Name:
ERICA
Provider Other Middle Name:
ANNICE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1265409833
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
25375 CLUB CIRCLE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
QUANTICO
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21856
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-860-2757
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1101 CAMDEN AVE SUITE 180
Provider Second Line Business Practice Location Address:
STUDENT HEALTH SERVICES HOLLOWAY HALL
Provider Business Practice Location Address City Name:
SALISBURY
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21801
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-543-6262
Provider Business Practice Location Address Fax Number:
410-548-7101
Provider Enumeration Date:
03/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  R130552 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 363LF0000X , with the licence number: R130552 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)





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