MRS. KELLY PRINE ALEXANDER (NPI# 1104277136) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104277136 |
| Entity Type | Individual |
| Full Name | MRS. KELLY PRINE ALEXANDER |
| Credential | AGACNP-BC |
| Practice Address |
969 Lakeland Dr Jackson MS 39216-4606 |
| Mailing Address |
Po Box 23457 Jackson MS 39225-3457 |
| Practice Telephone | 6012004466 |
| Practice Fax Number | 6012003651 |
| Mailing Telephone | 6012004466 |
| Mailing Fax Number | 6012003651 |
| Enumeration Date | 2016-06-30 |
| Last Update Date | 2020-07-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
901619 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 07356036 | 05 | |
| MS | RAILROAD MEDICARE | P01770661 | 01 |
| MS | MEDICARE | 542520YKHV | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346802931 | Kelly Alexander | Counselor | 451 W . Chew Street, Allentown, PA 18102 | 2019-07-03 |
| 1386194975 | Kelly Alexander | Rehabilitation Practitioner | 567 N 5th St # 153, Terre Haute, IN 47809-1903 | 2016-10-07 |
| 1043466071 | Kelly Alexander | Dentist | 2931 State Road, Cuyahoga Falls, OH 44223 | 2008-08-11 |
| 1275547861 | Kelly Alexander | Physical Therapist | 144 Evergreen Pkwy, Lebanon, MO 65536-7056 | 2006-07-28 |
| 1356377212 | Kelly L Alexander | Surgery | 1199 Bush St Ste 400, San Francisco, CA 94109-5975 | 2006-06-23 |
| 1639666266 | Kelly A Alexander | Social Worker | 3737 Lander Rd, Cleveland, OH 44124-5712 | 2018-04-19 |
| 1164844288 | Kelly A Alexander | Counselor | 10001 Grand Ave, Franklin Park, IL 60131-2563 | 2014-01-08 |
| 1780026187 | Kelly Michelle Alexander | Physical Therapist | 5725 Corporate Way, Suite 108, West Palm Beach, FL 33407-2007 | 2013-07-25 |
| 1598776924 | Kelly Drew Alexander Jr. | Dentist | 104 E Washington St, Hollandale, MS 38748 | 2006-08-10 |
| Street Address |
969 LAKELAND DR |
| City | JACKSON |
| State | MS |
| Zip Code | 39216-4606 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306843131 | Joseph N Candelora | Pathology | 969 Lakeland Dr, Jackson, MS 39216-4606 | 2005-07-07 |
| 1316554736 | Brooke Collins | 969 Lakeland Dr, Jackson, MS 39216-4606 | 2020-09-29 | |
| 1972117232 | William Paul Coe | Nurse Practitioner | 969 Lakeland Dr, Jackson, MS 39216-4606 | 2020-09-03 |
| 1376157099 | Kathryn Taylor Parvin | Radiology | 969 Lakeland Dr, Jackson, MS 39216-4699 | 2020-09-01 |
| 1235741646 | Stephanie H Atkins | Student in an Organized Health Care Education/Training Program | 969 Lakeland Dr, Jackson, MS 39216-4606 | 2020-08-18 |
| 1063038636 | Ayanna Washington | Registered Nurse | 969 Lakeland Dr, Jackson, MS 39216-4606 | 2020-06-19 |
| 1669092227 | Christopher L Stephens | Nurse Anesthetist, Certified Registered | 969 Lakeland Dr, Jackson, MS 39216-4606 | 2020-04-23 |
| 1578190385 | Lindsey Elizabeth Jibol | Counselor | 969 Lakeland Dr, Jackson, MS 39216-4699 | 2020-03-24 |
| 1801436951 | Callie Bridges | Nurse Anesthetist, Certified Registered | 969 Lakeland Dr, Jackson, MS 39216-4606 | 2020-01-07 |
| 1053951194 | Zachary Halliwell | Nurse Anesthetist, Certified Registered | 969 Lakeland Dr, Jackson, MS 39216-4606 | 2020-01-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861011553 | Ashley Melancon Prewitt | Registered Nurse | St. Dominic's North Campus, Behavioral Health, Jackson, MS 39216 | 2020-04-13 |
| 1194353391 | Brianna Arrington | Student in an Organized Health Care Education/Training Program | Med/ Peds, 2500 N. State St., Jackson, MS 39216 | 2020-04-01 |
| 1720616485 | Roshina Khalid Khan | Student in an Organized Health Care Education/Training Program | Department of Anesthesiology, Ummc, 2500 N. State St., Jackson, MS 39216 | 2020-03-30 |
| 1275183550 | Amanda Lynn Morellato | Dentist | Ummc School of Dentistry, 2500 North State Street, Jackson, MS 39216 | 2019-09-18 |
| 1396305553 | Abhishek Chhabra | Student in an Organized Health Care Education/Training Program | Lakeland Family Medicine Clinic, 878 Lakeland Dr., Jackson, MS 39216 | 2019-06-19 |
| 1427615996 | Hometown Diagnostics | Clinical Medical Laboratory | Translational Research Center Tr311, 2500 North State Street, Jackson, MS 39216 | 2019-05-21 |
| 1346807773 | Shukundala C Smith | Behavior Technician | New Learning Resources 2510 Lakeland Terrace, Jackson, MS 39216 | 2019-05-21 |
| 1063901098 | G Eli Howell Md Pllc | Plastic Surgery | 971 Lakeland Dr Ste 225, Jackson, MS 39216 | 2018-05-04 |
| 1588168132 | Caleb Zumbro | Student in an Organized Health Care Education/Training Program | Ummc Med/peds, 2500 N. State St., Jackson, MS 39216 | 2018-03-20 |
| 1639677230 | Walgreen Co | Pharmacy | 971 Lakeland Dr Ste 101, Jackson, MS 39216 | 2018-01-29 |
| Find all providers in zip 39216 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700240397 | Veronique Monique Lynch | Nurse Practitioner | 963 Toms River Rd, Jackson, NJ 08527-5239 | 2016-04-08 |
| 1821423484 | Katherine G Lott | Nurse Practitioner | 6295 Old Canton Rd, Apt 23b, Jackson, MS 39211-2908 | 2013-09-13 |
| 1760618292 | Matthew Edward Flynn | Nurse Practitioner | 971 Lakeland Dr Ste 1052, Jackson, MS 39216-4609 | 2009-06-10 |
| 1326649336 | Sharron Rena Brown | Nurse Practitioner | 1225 N State St, Jackson, MS 39202-2097 | 2020-11-05 |
| 1396346607 | Ashleigh Renfroe Hannah | Nurse Practitioner | 2500 N State St, Jackson, MS 39216-4500 | 2020-11-03 |
| 1770182438 | Tara P. Carter | Nurse Practitioner | 2500 N State St, Jackson, MS 39216-4500 | 2020-10-22 |
| 1437785508 | Katey Andrews | Nurse Practitioner | 2500 N State St, Jackson, MS 39216-4500 | 2020-03-20 |
| 1144854498 | Katlyn Amason | Nurse Practitioner | 501 Marshall St Ste 200, Jackson, MS 39202-1687 | 2020-02-25 |
| 1194364554 | Erica L Hawkins | Nurse Practitioner | 900 Cooper St, Jackson, MI 49202-3398 | 2020-01-03 |
| 1023664430 | Jennifer Elizabeth Overton | Nurse Practitioner | 2500 N State St, Jackson, MS 39216-4500 | 2019-08-12 |
| Find all providers in JACKSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.