MEDICARE: ALEXANDRA MICHELE KELLER

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	363A00000X	Physician Assistant	7080	TN

General Provider Information

NPI Number	:	1598628885
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRA MICHELE KELLER

Provider Business Mailing Address
First Line	:	3841 GREEN HILLS VILLAGE DR STE 200
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37215-2691
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1301 MEDICAL CENTER DR
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37232-0028
Country	:	US
Telephone Number	:	615-322-5000
Fax Number	:

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

Provider Enumeration Date	:	12/04/2025
Last Update Date	:	04/28/2026

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