Provider Demographics
NPI:1750146775
Name:ALEXANDER, ANISHA (DNP, AGPCNP-C, WCC)
Entity type:Individual
Prefix:DR
First Name:ANISHA
Middle Name:
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:DNP, AGPCNP-C, WCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 BENTWATER CT
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-8574
Mailing Address - Country:US
Mailing Address - Phone:601-551-2099
Mailing Address - Fax:
Practice Address - Street 1:8317 OFFICE PARK DR
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134-6936
Practice Address - Country:US
Practice Address - Phone:770-383-1951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN325358363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology