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General NPI Number Information
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NPI Number | 1649113036
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Entity Type | Organization
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Legal Business Name | ALEXANDER WELLNESS, LLC
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Dates
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Enumeration Date | 04/11/2026
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Last Update Date | 04/11/2026
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Provider Practice Location Address
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Address Line | 6709 N GAVIN LOOP
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City | COEUR D ALENE
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State | ID
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Zip | 83815-0050
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Country | US
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Telephone | 208-755-1887
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Fax | 208-556-7824
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Provider Business Mailing Address
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Address Line | 6709 N GAVIN LOOP
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City | COEUR D ALENE
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State | ID
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Zip | 83815-0050
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Country | US
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Telephone | 208-755-1887
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Fax | 208-556-7824
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Authorized Official
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Title or Position | OWNER/CEO/PRACTITIONER
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Name | DR. JACQUELYN DEE ALEXANDER
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Credential | DNP, FNP-C
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Telephone | 208-755-1887
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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