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In 1890, Dr. Annie purchased a home at 410 North Tryon Street from R. J. Shipp of Catawba County for $3,500. This one-story home served as both her office and residence. Dr. Annie kept her horse and buggy in a stable behind the house and used it to visit patients all over the county. Soon, her parents moved in with Dr. Annie. Dr. J. B. Alexander ran a drugstore at 216 North Tryon Street and later wrote a number of volumes on Mecklenburg County History. In 1901, Dr. Annie remodeled her home, added another story and made other improvements. She kept her office at the front of her house. At any given time, patients stayed at her house. Ona Pope was Dr. Annie’s housekeeper until the doctor’s death in 1929. This 1903 photo was taken from the corner of 7th and Tryon Streets, looking north. The home of Annie Alexander at 410 N. Tryon is just beyond the church at 408 - in the center-left background as one looks at the photograph.

Beginning in 1890, Dr. Annie began purchasing rental properties to supplement her income. At one time she owned as many as twenty rental houses and commercial offices in Charlotte. According to her family, she made more from her real estate investments than she did from medicine.