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NPI Code Detail

MEDICARE: TINA ALEXANDER PMHNP

MEDICARE:   TINA  ALEXANDER  PMHNP
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner10627MN
2363LP0808XPsychiatric/Mental Health Nurse PractitionerAPRN11015720FL
3163W00000XRegistered NurseRN9381520FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
110627OTHERMNCNP LICENSE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1982376968
Entity Type Code : Individual
Provider Name (Legal Business Name) : TINA ALEXANDER PMHNP
Provider Business Mailing Address
First Line : 4310 METRO PKWY STE 205
Second Line :
City : FORT MYERS
State : FL
Zip : 33916-9416
Country : US
Telephone Number : 239-236-8784
Fax Number : 239-790-2624
Provider Business Practice Location Address
First Line : 7201 METRO BLVD STE 205
Second Line :
City : EDINA
State : MN
Zip : 55439-1300
Country : US
Telephone Number : 952-260-7913
Fax Number : 952-333-7455
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2021
Last Update Date : 02/12/2024

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