# CORALYN J ALEXANDER MD PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013191915
- **Authorized official:** CORALYN ALEXANDER MD (OWNER)
- **Authorized official phone:** (208) 734-3900

## Contact information

- **Practice address:** 488 BLUE LAKES BLVD N, STE 102, TWIN FALLS, ID 83301-4800
- **Practice address phone:** (208) 734-3900
- **Practice address fax:** (208) 734-9441
- **Mailing address:** PO BOX 2103, TWIN FALLS, ID 83303-2103
- **Mailing address phone:** (208) 734-3900
- **Mailing address fax:** (208) 734-9441

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | M6940 | ID | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | NP662 | ID | Yes |

## Other

- **Enumeration date:** 12/27/2007
- **Last updated:** 08/23/2010