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NPI Code Detail

MEDICARE: ALEXSA BILLUPS MSW

MEDICARE: ALEXSA BILLUPS MSW
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
1104100000XSocial Worker520AK

General Provider Information

NPI Number : 1285622266
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXSA BILLUPS MSW
Provider Business Mailing Address
First Line : 1405 NE 1ST ST
Second Line :
City : MOORE
State : OK
Zip : 73160-7801
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5700 ARNOLD ST
Second Line : 72 MDG/SGOH
City : TINKER AFB
State : OK
Zip : 73145-8105
Country : US
Telephone Number : 405-734-4390
Fax Number : 405-734-5399
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2005
Last Update Date : 07/08/2007

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