MEDICARE: MS. ALEXI HILDRETH PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	0110011390	VA

General Provider Information

NPI Number	:	1164396677
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ALEXI HILDRETH PA-C

Provider Business Mailing Address
First Line	:	7051 HEATHCOTE VILLAGE WAY STE 210
Second Line	:
City	:	GAINESVILLE
State	:	VA
Zip	:	20155-3199
Country	:	US
Telephone Number	:	571-261-1234
Fax Number	:	571-261-2235

Provider Business Practice Location Address
First Line	:	7051 HEATHCOTE VILLAGE WAY STE 210
Second Line	:
City	:	GAINESVILLE
State	:	VA
Zip	:	20155-3199
Country	:	US
Telephone Number	:	571-261-1234
Fax Number	:	571-261-2235

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/30/2025
Last Update Date	:	09/30/2025

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