Provider Demographics
NPI:1225870660
Name:MORRIS, ALEXANDRA TEDDY (FNP-C)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:TEDDY
Last Name:MORRIS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4163 ELDERBERRY DR NW
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-1406
Mailing Address - Country:US
Mailing Address - Phone:404-354-3292
Mailing Address - Fax:
Practice Address - Street 1:1521 HICKORY FLAT HWY STE 200
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30115-3500
Practice Address - Country:US
Practice Address - Phone:470-297-1310
Practice Address - Fax:470-280-6579
Is Sole Proprietor?:No
Enumeration Date:2024-06-07
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN269505363LF0000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily