Provider Demographics
NPI:1992443675
Name:GODSEY, ALEXANDRA EVE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:EVE
Last Name:GODSEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:ALEXANDRA
Other - Middle Name:EVE
Other - Last Name:SPANGLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:535 CALVIN PHILLIPS DR
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601-6445
Mailing Address - Country:US
Mailing Address - Phone:423-431-9603
Mailing Address - Fax:
Practice Address - Street 1:2300 W STONE DR
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-2360
Practice Address - Country:US
Practice Address - Phone:423-246-4961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-23
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant