Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | RN140383 | GA |
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | RN140383 | GA |
NPI | 1508147844 |
---|---|
Provider Name | Cassie Alexander |
First Address | Evans, GA 30809-6077 |
Second Address | Augusta, GA 30912-0004 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2011 |
Last Update Date | 04/09/2014 |