Provider Demographics
NPI:1629220744
Name:FINK, ALICIA M (APRN)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:M
Last Name:FINK
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1595
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41105-1595
Mailing Address - Country:US
Mailing Address - Phone:606-408-6200
Mailing Address - Fax:606-408-6612
Practice Address - Street 1:2001 SCIOTO TRL STE 300
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-5122
Practice Address - Country:US
Practice Address - Phone:740-353-6390
Practice Address - Fax:740-353-6290
Is Sole Proprietor?:No
Enumeration Date:2008-10-21
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3006446363LF0000X
OH10341-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000754022OtherANTHEM BCBS
OH2964190Medicaid
KY7100115810Medicaid
WV3810017635Medicaid
KYP01312570OtherRR MEDICARE
KY000000847130OtherANTHEM BCBS
KYP01021227OtherRR MEDICARE
OH2964190Medicaid
KY7100115810Medicaid