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General NPI Number Information
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NPI Number | 1811503345
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Entity Type | Individual
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Provider Name | ALYSSA CORY HILDEBRAND NP-C
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Gender | Female
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Dates
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Enumeration Date | 09/21/2020
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Last Update Date | 11/29/2021
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Provider Practice Location Address
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Address Line | 2450 FONDREN RD STE 111
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City | HOUSTON
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State | TX
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Zip | 77063-2314
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Country | US
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Telephone | 713-201-9308
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Fax |
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Provider Business Mailing Address
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Address Line | 1300 OVERBOOK RD
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City | OVERLAND PARK
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State | KS
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Zip | 66224
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Country | US
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Telephone | 913-348-4330
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1011827
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 53-80523-031
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License Number State | KS
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