Provider Demographics
NPI:1417928854
Name:SPRINGER, ALICIA GAILE (NP)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:GAILE
Last Name:SPRINGER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16615 HIGHWAY 104 N
Mailing Address - Street 2:SUITE B
Mailing Address - City:LEXINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38351-5752
Mailing Address - Country:US
Mailing Address - Phone:731-968-0660
Mailing Address - Fax:731-968-0007
Practice Address - Street 1:16615 HIGHWAY 104 N
Practice Address - Street 2:SUITE B
Practice Address - City:LEXINGTON
Practice Address - State:TN
Practice Address - Zip Code:38351-5752
Practice Address - Country:US
Practice Address - Phone:731-968-0660
Practice Address - Fax:731-968-0007
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-01
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8026363LA2200X, 261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN443970OtherMEDICARE PART A PTAN
TN39094871OtherMEDICARE PART B PTAN
TN39094871Medicaid