Healthcare Provider Details

I. General information

NPI: 1487455853
Provider Name (Legal Business Name): ALEXANDRA NICOLE KELLER AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2025
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13181 OLD NASHVILLE HWY STE 150
SMYRNA TN
37167-4034
US

IV. Provider business mailing address

13181 OLD NASHVILLE HWY STE 150
SMYRNA TN
37167-4034
US

V. Phone/Fax

Practice location:
  • Phone: 615-355-5105
  • Fax:
Mailing address:
  • Phone: 615-355-5105
  • Fax: 615-355-5195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number38216
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: