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NPI 1730812330

NPI 1730812330 : ALEXA RAE HILL : RISON, AR

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General NPI Number Information
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    NPI Number           |    1730812330
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    Entity Type          |    Individual 
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    Provider Name        |    ALEXA RAE HILL
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/01/2022
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    Last Update Date     |    08/23/2024
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Provider Practice Location Address
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    Address Line         |    217 N MAIN ST 
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    City                 |    RISON
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    State                |    AR
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    Zip                  |    71665-8856
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    Country              |    US
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    Telephone            |    888-264-5034
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    303 GREEN AVE 
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    City                 |    WHITE HALL
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    State                |    AR
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    Zip                  |    71602-2627
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    363AM0700X
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    Taxonomy Name        |    Medical Physician Assistant
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    License Number       |    PA-1289
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    License Number State |    AR
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Taxonomy #2
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    Taxonomy Code        |    363A00000X
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    Taxonomy Name        |    Physician Assistant
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    License Number       |    
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    License Number State |    
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