Healthcare Provider Details

I. General information

NPI: 1386974400
Provider Name (Legal Business Name): ELIZABETH ALEXANDER PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2010
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 BILLINGSLEY RD
CHARLOTTE NC
28211-1002
US

IV. Provider business mailing address

100 BILLINGSLEY RD
CHARLOTTE NC
28211-1002
US

V. Phone/Fax

Practice location:
  • Phone: 980-880-4924
  • Fax: 704-376-3384
Mailing address:
  • Phone: 704-376-7447
  • Fax: 704-376-3384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number5009173
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number5009173
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: