Healthcare Provider Details

I. General information

NPI: 1275136665
Provider Name (Legal Business Name): ALEXANDRA CAITLIN PHILPOTT NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2020
Last Update Date: 03/20/2026
Certification Date: 03/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1403 E HAYLOFT DR
OZARK MO
65721-5378
US

IV. Provider business mailing address

1403 E HAYLOFT DR
OZARK MO
65721-5378
US

V. Phone/Fax

Practice location:
  • Phone: 417-254-1993
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2020036771
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: