Provider Demographics
NPI:1417771643
Name:HANSEN, ALEXANDRA LYNNE (PT, DPT)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:LYNNE
Last Name:HANSEN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 CHEROKEE RD
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-3704
Mailing Address - Country:US
Mailing Address - Phone:615-300-2892
Mailing Address - Fax:
Practice Address - Street 1:208 CHEROKEE RD
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-3704
Practice Address - Country:US
Practice Address - Phone:615-300-2892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-13
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VACP037183T225100000X
TN12786225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist