Healthcare Provider Details

I. General information

NPI: 1184131765
Provider Name (Legal Business Name): HOPE ANNETTE ALEXANDER FAMILY NURSE PRACTIT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/04/2018
Last Update Date: 01/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

412 NAMOZINE ST
BURKEVILLE VA
23922-3184
US

IV. Provider business mailing address

1532 REDLAWN RD
BOYDTON VA
23917-3605
US

V. Phone/Fax

Practice location:
  • Phone: 434-767-5511
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number0024175668
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: