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Individual

ALEXANDRA ROSE MUDD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1600 ACCELERATOR WAY, KNOXVILLE, TN 37920-3078
(865) 546-2663
(865) 546-9047
Mailing address
1600 ACCELERATOR WAY, KNOXVILLE, TN 37920-3078
(865) 546-2663
(865) 546-9047

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4685
TN
363A00000X
Physician Assistant
PA2416
KY
363AS0400X
Surgical Physician Assistant
4685
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100612140
KY
Enumeration date
10/30/2018
Last updated
08/15/2022
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