| Organization Name: | CORALYN J ALEXANDER MD PA |
| NPI Number: | 1013191915 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CORALYN ALEXANDER (OWNER) |
| Mailing Address: | 488 Blue Lakes Blvd N Ste 102 Twin Falls |
| State: | ID US |
| Postal Code: | 833014800 |
| Phone Number: | 2087343900 |
| Fax Number: | 2087349441 |
| NPI Enumeration Date: | 12/27/2007 |
| NPI Last Update Date: | 08/23/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | M6940 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | ID |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |