Provider Demographics
NPI:1063948602
Name:ALEXANDER, REBECCA J (APRN)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:J
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 E ELKINS ST
Mailing Address - Street 2:
Mailing Address - City:STANTON
Mailing Address - State:KY
Mailing Address - Zip Code:40380-2311
Mailing Address - Country:US
Mailing Address - Phone:606-663-2511
Mailing Address - Fax:606-663-0711
Practice Address - Street 1:330 SEVEN SPRINGS WAY
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-5098
Practice Address - Country:US
Practice Address - Phone:615-920-7905
Practice Address - Fax:615-920-8935
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-02
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY3011281363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily