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General NPI Number Information
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NPI Number | 1467759035
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Entity Type | Individual
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Provider Name | JACLYN HALEY ALEXANDER APRN
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Gender | Female
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Dates
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Enumeration Date | 02/17/2011
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Last Update Date | 08/06/2024
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Provider Practice Location Address
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Address Line | 4010 DUPONT CIR STE L07
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City | LOUISVILLE
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State | KY
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Zip | 40207-4812
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Country | US
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Telephone | 502-895-6559
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Fax | 502-895-8994
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Provider Business Mailing Address
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Address Line | 4010 DUPONT CIR STE L07
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City | LOUISVILLE
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State | KY
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Zip | 40207-4812
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Country | US
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Telephone | 502-895-6559
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Fax | 502-895-8994
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 3006642
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License Number State | KY
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