Provider Demographics
NPI:1033819693
Name:HIGHTOWER, ALEXANDRIA RAE
Entity Type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:RAE
Last Name:HIGHTOWER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 MAIN LN APT 1141
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-3865
Mailing Address - Country:US
Mailing Address - Phone:706-566-9302
Mailing Address - Fax:
Practice Address - Street 1:1415 SLIGH BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-3954
Practice Address - Country:US
Practice Address - Phone:706-566-9302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-03
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2833448163WC0200X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine