Provider Demographics
NPI:1053892398
Name:ALEXANDER, EARNESTINE (RN)
Entity type:Individual
Prefix:
First Name:EARNESTINE
Middle Name:
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3477 CROSS CREEK DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36116-3654
Mailing Address - Country:US
Mailing Address - Phone:334-462-8931
Mailing Address - Fax:334-281-9052
Practice Address - Street 1:3477 CROSS CREEK DR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-3654
Practice Address - Country:US
Practice Address - Phone:334-462-8931
Practice Address - Fax:334-281-9052
Is Sole Proprietor?:No
Enumeration Date:2018-08-24
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-060246163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health