Healthcare Provider Details

I. General information

NPI: 1336835883
Provider Name (Legal Business Name): ALEXANDRA M STEADMAN-COWAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2023
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 MED TECH PKWY STE 200
JOHNSON CITY TN
37604-2641
US

IV. Provider business mailing address

1021 W OAKLAND AVE STE 310
JOHNSON CITY TN
37604-2192
US

V. Phone/Fax

Practice location:
  • Phone: 423-794-1300
  • Fax: 423-794-1820
Mailing address:
  • Phone: 423-952-2111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number33652
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: