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General NPI Number Information
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NPI Number | 1346519840
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Entity Type | Organization
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Legal Business Name | ALEXANDER MEDICAL ASSOCIATES
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Dates
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Enumeration Date | 12/29/2011
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Last Update Date | 05/29/2012
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Provider Practice Location Address
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Address Line | 40 NEW YORK AVE
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City | OAK RIDGE
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State | TN
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Zip | 37830-6409
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Country | US
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Telephone | 865-483-4015
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Fax | 865-483-4016
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Provider Business Mailing Address
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Address Line | 40 NEW YORK AVE
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City | OAK RIDGE
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State | TN
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Zip | 37830-6409
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Country | US
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Telephone | 865-483-4015
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Fax | 865-483-4016
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MS. TRACY L JENKINS
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Credential | N.P.
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Telephone | 865-483-4015
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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 | 14992
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License Number State | TN
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