Provider Demographics
NPI:1659127280
Name:ALEXANDER, MINDY BAINE
Entity type:Individual
Prefix:
First Name:MINDY
Middle Name:BAINE
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 1:275 ALEXANDER LOVE HWY E
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:SC
Mailing Address - Zip Code:29745-5502
Mailing Address - Country:US
Mailing Address - Phone:180-323-0839
Mailing Address - Fax:
Practice Address - Street 1:275 ALEXANDER LOVE HWY E
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:SC
Practice Address - Zip Code:29745-5502
Practice Address - Country:US
Practice Address - Phone:180-323-0839
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-25
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC206320163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool