Healthcare Provider Details

I. General information

NPI: 1720818099
Provider Name (Legal Business Name): ALEXANDER NG PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2024
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 MEDICAL CENTER DR
NEWTON KS
67114-8778
US

IV. Provider business mailing address

720 MEDICAL CENTER DR
NEWTON KS
67114-8778
US

V. Phone/Fax

Practice location:
  • Phone: 316-283-6103
  • Fax: 316-283-1333
Mailing address:
  • Phone: 316-283-6103
  • Fax: 316-283-1333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number53-85522-012
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: