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Individual

ALEXANDRA BOURSIQUOT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4206 75TH AVE, HYATTSVILLE, MD 20784-2318
(240) 413-1255
(301) 576-8573
Mailing address
4206 75TH AVE, HYATTSVILLE, MD 20784-2318
(240) 413-1255
(301) 576-8573

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN1044797
DC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R226935
MD

Other

Enumeration date
07/11/2017
Last updated
11/25/2025
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