MEDICARE: ANN CAUGHMAN ALEXANDER RN MN CFNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	APN2257	SC
2	363L00000X	Nurse Practitioner	2257	SC

General Provider Information

NPI Number	:	1205829348
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANN CAUGHMAN ALEXANDER RN MN CFNP

Provider Business Mailing Address
First Line	:	811 W MAIN ST
Second Line	:	STE 204
City	:	LEXINGTON
State	:	SC
Zip	:	29072-2507
Country	:	US
Telephone Number	:	803-359-8855
Fax Number	:	803-359-1257

Provider Business Practice Location Address
First Line	:	811 W MAIN ST
Second Line	:	STE 204
City	:	LEXINGTON
State	:	SC
Zip	:	29072-2507
Country	:	US
Telephone Number	:	803-359-8855
Fax Number	:	803-359-1257

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2005
Last Update Date	:	03/05/2014

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