Provider Demographics
NPI:1194200055
Name:ALEXANDER, JELANA
Entity Type:Individual
Prefix:
First Name:JELANA
Middle Name:
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 1:136 DARGIN RD
Mailing Address - Street 2:
Mailing Address - City:SUNSET
Mailing Address - State:LA
Mailing Address - Zip Code:70584-5023
Mailing Address - Country:US
Mailing Address - Phone:337-322-5020
Mailing Address - Fax:337-514-2105
Practice Address - Street 1:19157 CROWLEY EUNICE HWY
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:LA
Practice Address - Zip Code:70526-0801
Practice Address - Country:US
Practice Address - Phone:337-514-2101
Practice Address - Fax:337-514-2105
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-26
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator