Provider Demographics
NPI:1891167599
Name:ALEXANDER, JITTY (APRN)
Entity Type:Individual
Prefix:
First Name:JITTY
Middle Name:
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:JITTY
Other - Middle Name:ELIZABETH
Other - Last Name:CHANDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7236 POPLAR CT
Mailing Address - Street 2:
Mailing Address - City:SHELBY TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48316-5869
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9611 W BROWARD BLVD
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2334
Practice Address - Country:US
Practice Address - Phone:954-424-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-21
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11018592363L00000X, 363LP0200X
MI4704289538363L00000X, 363LP0200X
TX1033414363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner