Provider Demographics
NPI:1881008498
Name:ALEXANDER, SHELLY DION (FNP)
Entity Type:Individual
Prefix:
First Name:SHELLY
Middle Name:DION
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:SHELLY
Other - Middle Name:
Other - Last Name:BARGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4412 HEATHER LN
Mailing Address - Street 2:
Mailing Address - City:BOLIVAR
Mailing Address - State:MO
Mailing Address - Zip Code:65613-9301
Mailing Address - Country:US
Mailing Address - Phone:417-298-4433
Mailing Address - Fax:
Practice Address - Street 1:3380 C ST STE 100
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-3949
Practice Address - Country:US
Practice Address - Phone:417-298-4433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-12
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014000660363LF0000X
ARA004139363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily