Provider Demographics
NPI:1245873215
Name:NORTH, ALEXANDRA MICHELLE (PA)
Entity type:Individual
Prefix:MISS
First Name:ALEXANDRA
Middle Name:MICHELLE
Last Name:NORTH
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:1005 DR DB TODD JR BLVD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37208-3501
Mailing Address - Country:US
Mailing Address - Phone:615-327-5944
Mailing Address - Fax:615-327-5597
Practice Address - Street 1:1005 DR DB TODD JR BLVD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37208-3501
Practice Address - Country:US
Practice Address - Phone:615-327-6000
Practice Address - Fax:615-327-5597
Is Sole Proprietor?:No
Enumeration Date:2019-10-23
Last Update Date:2020-06-30
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Provider Licenses
StateLicense IDTaxonomies
TN3957363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ056179Medicaid