Provider Demographics
NPI:1063303865
Name:ALEXANDER, JAVONA (NP)
Entity type:Individual
Prefix:MS
First Name:JAVONA
Middle Name:
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3042 NICHOLAS RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45417-4323
Mailing Address - Country:US
Mailing Address - Phone:937-270-3405
Mailing Address - Fax:
Practice Address - Street 1:2000 WATERSTONE BLVD APT 205
Practice Address - Street 2:
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342-0524
Practice Address - Country:US
Practice Address - Phone:937-270-3405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-10
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH480299363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty