Provider Demographics
NPI:1194212332
Name:ALEXANDER, AMANDA (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 W CLEVELAND ST # S620
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-1937
Mailing Address - Country:US
Mailing Address - Phone:910-922-3833
Mailing Address - Fax:
Practice Address - Street 1:7118 MAIN ST
Practice Address - Street 2:
Practice Address - City:WADE
Practice Address - State:NC
Practice Address - Zip Code:28395-9749
Practice Address - Country:US
Practice Address - Phone:910-483-6694
Practice Address - Fax:910-483-2215
Is Sole Proprietor?:No
Enumeration Date:2018-04-13
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC298400163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health