Provider Demographics
NPI:1053175414
Name:IVEY, ALEJANDRA (DNP, PMHNP)
Entity type:Individual
Prefix:DR
First Name:ALEJANDRA
Middle Name:
Last Name:IVEY
Suffix:
Gender:F
Credentials:DNP, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3816 LONDON BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SYKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21784-9513
Mailing Address - Country:US
Mailing Address - Phone:307-286-5529
Mailing Address - Fax:
Practice Address - Street 1:3816 LONDON BRIDGE RD
Practice Address - Street 2:
Practice Address - City:SYKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21784-9513
Practice Address - Country:US
Practice Address - Phone:307-286-5529
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR253632363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health