Provider Demographics
NPI:1689807539
Name:ALEXANDER, RETHA ELIZABETH (APN)
Entity Type:Individual
Prefix:
First Name:RETHA
Middle Name:ELIZABETH
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 MOUNTAIN VIEW DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:VONORE
Mailing Address - State:TN
Mailing Address - Zip Code:37885-2666
Mailing Address - Country:US
Mailing Address - Phone:423-884-2308
Mailing Address - Fax:423-884-2929
Practice Address - Street 1:125 MOUNTAIN VIEW DR
Practice Address - Street 2:SUITE 200
Practice Address - City:VONORE
Practice Address - State:TN
Practice Address - Zip Code:37885-2666
Practice Address - Country:US
Practice Address - Phone:423-884-2308
Practice Address - Fax:423-884-2929
Is Sole Proprietor?:No
Enumeration Date:2009-08-26
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6917363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health