Basic Information
| Provider Information | |||||||||
| NPI: | 1851905491 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BURLEY | ||||||||
| FirstName: | ALEXA | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | CRNP-PMH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 814 RUSTIC LN | ||||||||
| Address2: | |||||||||
| City: | LOTHIAN | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207119403 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4104741765 | ||||||||
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| Practice Location | |||||||||
| Address1: | 300 BYRN ST | ||||||||
| Address2: | |||||||||
| City: | CAMBRIDGE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 216131908 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4102285511 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/01/2020 | ||||||||
| LastUpdateDate: | 09/01/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/01/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | R225890 | MD | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.