MRS. KELLY PRINE ALEXANDER AGACNP-BC NPI 1104277136

NPI Information

NPI: 1104277136
Provider Name: MRS. KELLY PRINE ALEXANDER, AGACNP-BC
Classification: Nurse Practitioner - 363LA2100X
Entity Type: Individual

Specialization: Acute Care

PECOS Registration: Yes

Address:
969 LAKELAND DR
JACKSON, MS
ZIP 39216
Phone: (601) 200-4466
Get Directions

MRS. Kelly Prine Alexander, AGACNP-BC is an acute care nurse practitioner in Jackson, MS. MRS. Kelly Prine Alexander, AGACNP-BC NPI is 1104277136. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

969 LAKELAND DR
JACKSON, MS
ZIP 39216-606
Phone: (601) 200-4466
Fax: (601) 200-3651

The NPI 1104277136 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/30/2016 and was last updated on 7/20/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2100X	Nurse Practitioner	Acute Care	901619	MISSISSIPPI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	07356036	MEDICAID	MISSISSIPPI
2	P01770661	OTHER	MISSISSIPPI	RAILROAD MEDICARE
3	542520YKHV	OTHER	MISSISSIPPI	MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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