Provider Demographics
NPI:1487443701
Name:PEREZ, ALEXANDRA RAE (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:RAE
Last Name:PEREZ
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 BEACON DR
Mailing Address - Street 2:
Mailing Address - City:BARNEGAT
Mailing Address - State:NJ
Mailing Address - Zip Code:08005-1459
Mailing Address - Country:US
Mailing Address - Phone:732-501-4314
Mailing Address - Fax:
Practice Address - Street 1:2003 LINCOLN DR W STE B
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-1529
Practice Address - Country:US
Practice Address - Phone:856-886-8839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-02
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15307100363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health