Provider Demographics
NPI:1861216053
Name:ALEXANDER, KETURAH LOUISE BURNS (APRN, FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:KETURAH
Middle Name:LOUISE BURNS
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 627
Mailing Address - Street 2:
Mailing Address - City:MILLEN
Mailing Address - State:GA
Mailing Address - Zip Code:30442-0627
Mailing Address - Country:US
Mailing Address - Phone:478-982-2811
Mailing Address - Fax:478-982-1589
Practice Address - Street 1:709 VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:MILLEN
Practice Address - State:GA
Practice Address - Zip Code:30442-5270
Practice Address - Country:US
Practice Address - Phone:478-982-2811
Practice Address - Fax:478-982-2811
Is Sole Proprietor?:No
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN298447363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily