Provider Demographics
NPI:1477950327
Name:HUESTIS, ALISHA (APRN FNP-C)
Entity Type:Individual
Prefix:
First Name:ALISHA
Middle Name:
Last Name:HUESTIS
Suffix:
Gender:F
Credentials:APRN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 COGDELL BLVD
Mailing Address - Street 2:
Mailing Address - City:SNYDER
Mailing Address - State:TX
Mailing Address - Zip Code:79549-6162
Mailing Address - Country:US
Mailing Address - Phone:806-577-7323
Mailing Address - Fax:325-574-7433
Practice Address - Street 1:1700 COGDELL BLVD
Practice Address - Street 2:
Practice Address - City:SNYDER
Practice Address - State:TX
Practice Address - Zip Code:79549
Practice Address - Country:US
Practice Address - Phone:325-574-7437
Practice Address - Fax:325-574-7433
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-20
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP126608363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily