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General NPI Number Information
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NPI Number | 1033051842
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Entity Type | Individual
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Provider Name | ALEXA MEDLOCK APRN
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Gender | Female
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Dates
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Enumeration Date | 04/08/2026
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Last Update Date | 04/08/2026
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Provider Practice Location Address
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Address Line | 28 BUSINESS PARK DR
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City | GREENBRIER
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State | AR
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Zip | 72058-8068
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Country | US
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Telephone | 501-679-0870
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Fax |
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Provider Business Mailing Address
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Address Line | 735 CHARTON RD
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City | PLUMERVILLE
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State | AR
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Zip | 72127-8882
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Country | US
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Telephone | 501-679-0870
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 236793
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License Number State | AR
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