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General NPI Number Information
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NPI Number | 1952684268
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Entity Type | Individual
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Provider Name | ALICIA M. ALEXANDER CPNP, PMHS
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Gender | Female
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Dates
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Enumeration Date | 09/22/2011
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Last Update Date | 09/20/2024
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Provider Practice Location Address
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Address Line | 474 INDUSTRIAL LANE PEDIATRIC CLINIC-ONEIDA
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City | ONEIDA
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State | TN
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Zip | 37841-4685
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Country | US
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Telephone | 423-286-8600
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Fax | 423-286-8644
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Provider Business Mailing Address
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Address Line | 9000 EXECUTIVE PARK DR C200
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City | KNOXVILLE
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State | TN
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Zip | 37923-4685
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Country | US
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Telephone | 865-670-6199
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Fax | 865-670-6188
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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 | 2080P0006X
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Taxonomy Name | Developmental - Behavioral Pediatrics Physician
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License Number | 20227510
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 2080P0008X
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Taxonomy Name | Pediatric Neurodevelopmental Disabilities Physician
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License Number | 20227510
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 364SP0200X
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Taxonomy Name | Pediatric Clinical Nurse Specialist
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License Number | 16121
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License Number State | TN
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