Provider Demographics
NPI:1215606678
Name:GOLLY, ALEKSANDRA (RN, FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:ALEKSANDRA
Middle Name:
Last Name:GOLLY
Suffix:
Gender:F
Credentials:RN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 HIGH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-2662
Mailing Address - Country:US
Mailing Address - Phone:978-685-2460
Mailing Address - Fax:978-685-2572
Practice Address - Street 1:47 HIGH ST STE 101
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-2662
Practice Address - Country:US
Practice Address - Phone:978-685-2460
Practice Address - Fax:978-685-2572
Is Sole Proprietor?:No
Enumeration Date:2021-09-09
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2338052363LF0000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily