Provider Demographics
NPI:1205179249
Name:ALEXANDER, JENNIFER MARIE (FNP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MARIE
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3605 SHADY FOREST DR
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37128-6703
Mailing Address - Country:US
Mailing Address - Phone:615-426-3252
Mailing Address - Fax:
Practice Address - Street 1:1801 N WASHINGTON ST
Practice Address - Street 2:SUITE 600
Practice Address - City:TULLAHOMA
Practice Address - State:TN
Practice Address - Zip Code:37388-8245
Practice Address - Country:US
Practice Address - Phone:931-913-2878
Practice Address - Fax:855-540-4722
Is Sole Proprietor?:No
Enumeration Date:2013-03-28
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1053220363LF0000X
AZAP11748363LF0000X
COC-APN.0001295-C-NP363LF0000X
WAAP60938559363LF0000X
TN17464363LF0000X
OR201906509363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1531300Medicaid
KY7100247520Medicaid
TN1531300Medicaid