Provider Demographics
NPI:1528544335
Name:ALEXANDER ROBERTSON, QUISHA SHERANE
Entity type:Individual
Prefix:
First Name:QUISHA
Middle Name:SHERANE
Last Name:ALEXANDER ROBERTSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:QUISHA
Other - Middle Name:SHERANE
Other - Last Name:ALEXANDER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 746722
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6722
Mailing Address - Country:US
Mailing Address - Phone:312-733-9730
Mailing Address - Fax:312-929-0373
Practice Address - Street 1:2401 W CHELTENHAM AVE
Practice Address - Street 2:
Practice Address - City:WYNCOTE
Practice Address - State:PA
Practice Address - Zip Code:19095-2946
Practice Address - Country:US
Practice Address - Phone:215-444-7471
Practice Address - Fax:215-695-2935
Is Sole Proprietor?:No
Enumeration Date:2018-07-15
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP018915363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily