Individual provider · NPI-1

Gretta Goines Alexander, FNP-BC

Nurse Practitioner, Family · Stockbridge, GA

NPI number1902622202

StatusActive

Last updated in NPPESJan 15, 2025

Details

NPI: 1902622202
Entity type: Individual (NPI-1)
Name: Gretta Goines Alexander
Credential: FNP-BC
Sex: Female
Sole proprietor: Yes
Enumeration date: Dec 2, 2024
Certification date: Jan 15, 2025
Last updated: Jan 15, 2025

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
363LF0000X	Nurse Practitioner, Family	RN176479	GA	Yes
163WH1000X	Registered Nurse, Hospice	RN176479	GA

Practice location

175 Country Club Dr
Stockbridge, GA 30281-9054

Phone 800-410-4663

Mailing address

1640 Fuma Leaf Way
Mcdonough, GA 30253-1948

Phone 229-520-1347

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.