Provider Demographics
NPI:1255186763
Name:ALEXANDER, JUDITH PAULA
Entity type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:PAULA
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6800 ROCKLAND RD
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30038-3207
Mailing Address - Country:US
Mailing Address - Phone:678-910-2157
Mailing Address - Fax:
Practice Address - Street 1:5855 JIMMY CARTER BLVD STE 260
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30071-4630
Practice Address - Country:US
Practice Address - Phone:770-776-6637
Practice Address - Fax:770-216-2004
Is Sole Proprietor?:No
Enumeration Date:2024-04-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN121553163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health