Provider Demographics
NPI:1851790216
Name:WEATHERSBY, ALEXANDRA BYERS (FNP-C)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:BYERS
Last Name:WEATHERSBY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1075 E WINTHROPE AVE
Mailing Address - Street 2:
Mailing Address - City:MILLEN
Mailing Address - State:GA
Mailing Address - Zip Code:30442-6766
Mailing Address - Country:US
Mailing Address - Phone:478-249-1200
Mailing Address - Fax:478-249-1203
Practice Address - Street 1:1075 E WINTHROPE AVE
Practice Address - Street 2:
Practice Address - City:MILLEN
Practice Address - State:GA
Practice Address - Zip Code:30442-6766
Practice Address - Country:US
Practice Address - Phone:478-249-1200
Practice Address - Fax:478-249-1203
Is Sole Proprietor?:No
Enumeration Date:2014-08-21
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN198560363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP4894Medicaid