Provider Demographics
NPI:1902181258
Name:ALEXANDER-LEWIS, SANDRA JEAN (MSN, FNP-C)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:JEAN
Last Name:ALEXANDER-LEWIS
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 RIVERVIEW DRIVE
Mailing Address - Street 2:P.O. BOX 1269
Mailing Address - City:WARSAW
Mailing Address - State:KY
Mailing Address - Zip Code:41095
Mailing Address - Country:US
Mailing Address - Phone:812-801-9535
Mailing Address - Fax:859-567-2758
Practice Address - Street 1:635 CHESTNUT DR
Practice Address - Street 2:
Practice Address - City:WALTON
Practice Address - State:KY
Practice Address - Zip Code:41094
Practice Address - Country:US
Practice Address - Phone:859-379-0040
Practice Address - Fax:859-379-0041
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-19
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71003738A363LF0000X
OHAPRN.CNP.024954363LF0000X
KY3007359363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY3007359OtherAPRN LICENSE