1447605753 NPI number — ANNE WHEELER ALEXANDROV PHD, AGACNP-BC

Table of content: ANNE WHEELER ALEXANDROV PHD, AGACNP-BC (NPI 1447605753)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447605753 NPI number — ANNE WHEELER ALEXANDROV PHD, AGACNP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALEXANDROV
Provider First Name:
ANNE
Provider Middle Name:
WHEELER
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PHD, AGACNP-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447605753
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/29/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
UTHSC COLLEGE OF NURSING
Provider Second Line Business Mailing Address:
920 MADISON, SUITE 532
Provider Business Mailing Address City Name:
MEMPHIS
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
38163-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
901-448-2659
Provider Business Mailing Address Fax Number:
901-552-5243

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
UTHSC COLLEGE OF NURSING
Provider Second Line Business Practice Location Address:
920 MADISON, SUITE 532
Provider Business Practice Location Address City Name:
MEMPHIS
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38163-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-448-2659
Provider Business Practice Location Address Fax Number:
901-552-5243
Provider Enumeration Date:
04/25/2016

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LA2100X , with the licence number:  21008 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: Q025240 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 220041758 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".