Provider Demographics
NPI:1760018501
Name:ALEXANDER, EMILY DAWN (FNP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:DAWN
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 1:9130 OLD STATE ROAD 135 NE
Mailing Address - Street 2:
Mailing Address - City:NEW SALISBURY
Mailing Address - State:IN
Mailing Address - Zip Code:47161-8666
Mailing Address - Country:US
Mailing Address - Phone:502-475-7350
Mailing Address - Fax:
Practice Address - Street 1:3701 FRANKFORT AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-2556
Practice Address - Country:US
Practice Address - Phone:502-259-9627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-12
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71009927A363LF0000X
KY3014278363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health