Provider Demographics
NPI:1790146454
Name:ALEXANDER, BRANDI (APRN)
Entity Type:Individual
Prefix:MRS
First Name:BRANDI
Middle Name:
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1232 S DINSMORE TRL
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72704-7602
Mailing Address - Country:US
Mailing Address - Phone:479-200-7678
Mailing Address - Fax:
Practice Address - Street 1:4301 GREATHOUSE SPRINGS ROAD
Practice Address - Street 2:
Practice Address - City:JOHNSON
Practice Address - State:AR
Practice Address - Zip Code:72741
Practice Address - Country:US
Practice Address - Phone:479-684-3260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-09
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA004684363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health