Healthcare Provider Details

I. General information

NPI: 1659374254
Provider Name (Legal Business Name): BILLY JO ALDERTON ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2005
Last Update Date: 09/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1603 MORGAN ST SUITE 3
KEOKUK IA
52632-3430
US

IV. Provider business mailing address

1603 MORGAN ST SUITE 3
KEOKUK IA
52632-3430
US

V. Phone/Fax

Practice location:
  • Phone: 319-524-4300
  • Fax: 319-524-5396
Mailing address:
  • Phone: 319-524-4300
  • Fax: 319-524-5396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberF097652
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: