Individual
BETTY JO ALEXANDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
517 FIFTH AVE, PICAYUNE, MS 39466-3203
(601) 590-1045
(601) 799-0052
Mailing address
517 FIFTH AVE, PICAYUNE, MS 39466-3203
(601) 590-1045
(601) 798-2052
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
687693
MS
363LP2300X
Primary Care Nurse Practitioner
AP03593
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00126950
—
MS
05
—
01808531
—
MS
01
—
R687693
LICENSE
MS
Enumeration date
02/14/2007
Last updated
01/17/2025
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