Provider Demographics
NPI:1710795844
Name:NOTTINGHAM, ALEXANDRA RENEE
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:RENEE
Last Name:NOTTINGHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 QUAKER VILLAGE LN
Mailing Address - Street 2:
Mailing Address - City:EAST SANDWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02537-1347
Mailing Address - Country:US
Mailing Address - Phone:925-586-6710
Mailing Address - Fax:
Practice Address - Street 1:31 QUAKER VILLAGE LN
Practice Address - Street 2:
Practice Address - City:EAST SANDWICH
Practice Address - State:MA
Practice Address - Zip Code:02537-1347
Practice Address - Country:US
Practice Address - Phone:925-586-6710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-20
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251S00000XAgenciesCommunity/Behavioral Health
No347C00000XTransportation ServicesPrivate Vehicle
No372600000XNursing Service Related ProvidersAdult Companion