Healthcare Provider Details

I. General information

NPI: 1205829348
Provider Name (Legal Business Name): ANN CAUGHMAN ALEXANDER RN MN CFNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2005
Last Update Date: 03/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 W MAIN ST STE 204
LEXINGTON SC
29072-2507
US

IV. Provider business mailing address

811 W MAIN ST STE 204
LEXINGTON SC
29072-2507
US

V. Phone/Fax

Practice location:
  • Phone: 803-359-8855
  • Fax: 803-359-1257
Mailing address:
  • Phone: 803-359-8855
  • Fax: 803-359-1257

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberAPN2257
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number2257
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: