Provider Demographics
NPI:1144933235
Name:ALEXANDER, JENNIFER RAE (APRN, PMHMP-BC)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:RAE
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:APRN, PMHMP-BC
Other - Prefix:
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Other - Suffix:
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Mailing Address - Street 1:106 SUMMIT DR
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:KY
Mailing Address - Zip Code:42064-1249
Mailing Address - Country:US
Mailing Address - Phone:270-969-1995
Mailing Address - Fax:
Practice Address - Street 1:141 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:KY
Practice Address - Zip Code:42078-8043
Practice Address - Country:US
Practice Address - Phone:270-988-3298
Practice Address - Fax:270-988-4642
Is Sole Proprietor?:No
Enumeration Date:2023-01-04
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY3018838363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health