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General NPI Number Information
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NPI Number | 1861216053
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Entity Type | Individual
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Provider Name | KETURAH LOUISE BURNS ALEXANDER APRN, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 11/13/2024
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 709 VIRGINIA AVE
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City | MILLEN
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State | GA
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Zip | 30442-5270
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Country | US
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Telephone | 478-982-2811
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Fax | 478-982-2811
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Provider Business Mailing Address
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Address Line | PO BOX 627
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City | MILLEN
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State | GA
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Zip | 30442-0627
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Country | US
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Telephone | 478-982-2811
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Fax | 478-982-1589
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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 | RN298447
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License Number State | GA
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