Provider Demographics
NPI:1235863572
Name:BOTTS, ALEXANDRA PAIGE (PA-C)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:PAIGE
Last Name:BOTTS
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:1000 BROOKFIELD RD STE 100
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-0853
Mailing Address - Country:US
Mailing Address - Phone:901-779-6538
Mailing Address - Fax:901-685-2717
Practice Address - Street 1:1000 BROOKFIELD RD STE 100
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-0853
Practice Address - Country:US
Practice Address - Phone:901-779-6538
Practice Address - Fax:901-685-2717
Is Sole Proprietor?:No
Enumeration Date:2022-07-12
Last Update Date:2022-12-28
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant