Provider Demographics
NPI:1891342192
Name:ALEXANDER, LINDA FAYE
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:FAYE
Last Name:ALEXANDER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5295 HIGHWAY 54
Mailing Address - Street 2:
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71603-8538
Mailing Address - Country:US
Mailing Address - Phone:870-413-0294
Mailing Address - Fax:
Practice Address - Street 1:5295 HIGHWAY 54
Practice Address - Street 2:
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71603-8538
Practice Address - Country:US
Practice Address - Phone:870-413-0294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-21
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider