Keegan Alexander, LPN

Individual provider Active NPI Licensed Practical Nurse · Lilburn, GA

NPI 1245802073 · NPPES record last updated Sep 27, 2021

Key facts

NPI
1245802073
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
070606 (GA)
Practice address
4305 Paxton LN SW Apt 809
Lilburn, GA 30047-8401
Phone
(678) 599-4051
NPI assigned
Jul 12, 2021
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
070606GAMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Select Nursing LLC Current
since Jul 20, 2021
Accepting new patients
Select Nursing Co Limited LTD Current Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 070606 GA Yes

Addresses

Primary practice location

4305 Paxton LN SW Apt 809
Lilburn, GA 30047-8401

Mailing address

4305 Paxton LN SW Apt 809
Lilburn, GA 30047-8401
Phone (678) 599-4051

Other providers in Lilburn, GA

All providers in Lilburn, GA · Licensed Practical Nurse in Georgia

Sources for this page

Verify at the official NPI Registry.