Basic Information
| Provider Information | |||||||||
| NPI: | 1295083517 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALEXANDER | ||||||||
| FirstName: | AMY | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 716 W BROADWAY | ||||||||
| Address2: | SUITE 2 | ||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402022216 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5022389911 | ||||||||
| FaxNumber: | 5022389912 | ||||||||
| Practice Location | |||||||||
| Address1: | 716 W BROADWAY | ||||||||
| Address2: | |||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402022216 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5025957744 | ||||||||
| FaxNumber: | 5025957007 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/16/2012 | ||||||||
| LastUpdateDate: | 06/24/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 1113681 | KY | N | Nursing Service Providers | Registered Nurse | 363L00000X | 71004079A | IN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363L00000X | 3007666 | KY | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.