Most Relevant Information
Provider Data
| NPI Number: | 1003397365 |
| Provider Name: | ALEXANDRIA MARIE BAKOS CRNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | SP019131 |
Most Important Dates
| Enumeration Date: | 08/24/2018 |
| Last Updated: | 08/24/2018 |
Provider Practice Location
1070 OLD NATIONAL PIKE
FREDERICKTOWN
PA
153332114
Practice Location Phone/Fax
| Phone: | 7246326801 |
| Fax: |
Provider Mailing Location
139 W CHURCH ST
FAIRCHANCE
PA
154361107
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |