Provider Demographics
NPI:1447605753
Name:ALEXANDROV, ANNE WHEELER (PHD, AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:WHEELER
Last Name:ALEXANDROV
Suffix:
Gender:F
Credentials:PHD, AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UTHSC COLLEGE OF NURSING
Mailing Address - Street 2:920 MADISON, SUITE 532
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38163-0001
Mailing Address - Country:US
Mailing Address - Phone:901-448-2659
Mailing Address - Fax:901-552-5243
Practice Address - Street 1:UTHSC COLLEGE OF NURSING
Practice Address - Street 2:920 MADISON, SUITE 532
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38163-0001
Practice Address - Country:US
Practice Address - Phone:901-448-2659
Practice Address - Fax:901-552-5243
Is Sole Proprietor?:No
Enumeration Date:2016-04-25
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN21008363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ025240Medicaid
AR220041758Medicaid