Provider Demographics
NPI:1144263880
Name:ALEXANDER, DOROTHY EDWARDS (FNP)
Entity type:Individual
Prefix:MRS
First Name:DOROTHY
Middle Name:EDWARDS
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3950 NEW COVINGTON PIKE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38128-2593
Mailing Address - Country:US
Mailing Address - Phone:901-382-5256
Mailing Address - Fax:901-382-5256
Practice Address - Street 1:3950 NEW COVINGTON PIKE
Practice Address - Street 2:STE 300
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38128-2593
Practice Address - Country:US
Practice Address - Phone:901-382-5256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN000043058363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3641789Medicaid
MA0652536OtherDEA
TN3378650Medicare ID - Type UnspecifiedGRP #
MA0652536OtherDEA
P25787Medicare UPIN