Provider Demographics
NPI:1780383927
Name:BAUER, ALEXA (CRNP)
Entity type:Individual
Prefix:
First Name:ALEXA
Middle Name:
Last Name:BAUER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:ALEXA
Other - Middle Name:
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:110 HOSPITAL RD STE 111
Mailing Address - Street 2:
Mailing Address - City:PRINCE FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:20678-4039
Mailing Address - Country:US
Mailing Address - Phone:410-535-4488
Mailing Address - Fax:443-771-8114
Practice Address - Street 1:110 HOSPITAL RD STE 111
Practice Address - Street 2:
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678-4039
Practice Address - Country:US
Practice Address - Phone:410-535-4488
Practice Address - Fax:443-771-8114
Is Sole Proprietor?:No
Enumeration Date:2023-02-27
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR247885363LF0000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse