Provider Demographics
NPI:1831360411
Name:DUNCAN, ALEXANDRIA NICOLE (WHANP-BC)
Entity type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:NICOLE
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:WHANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3076 BARNES BEND DR
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-4479
Mailing Address - Country:US
Mailing Address - Phone:615-400-0075
Mailing Address - Fax:
Practice Address - Street 1:230 DOVER ROAD
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37042
Practice Address - Country:US
Practice Address - Phone:931-920-5000
Practice Address - Fax:931-920-5011
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-21
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000013309363LA2200X
TN13309363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3340187Medicaid