Provider Demographics
NPI:1639726813
Name:HIGHTOWER, ALISHA CARTER
Entity Type:Individual
Prefix:
First Name:ALISHA
Middle Name:CARTER
Last Name:HIGHTOWER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALISHA
Other - Middle Name:MONTYNE
Other - Last Name:CARTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 497
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:AR
Mailing Address - Zip Code:72006-0497
Mailing Address - Country:US
Mailing Address - Phone:870-347-2534
Mailing Address - Fax:
Practice Address - Street 1:2450 BATESVILLE BLVD
Practice Address - Street 2:
Practice Address - City:SOUTHSIDE
Practice Address - State:AR
Practice Address - Zip Code:72501-7782
Practice Address - Country:US
Practice Address - Phone:870-569-4934
Practice Address - Fax:870-569-4948
Is Sole Proprietor?:No
Enumeration Date:2019-08-21
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR120482363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily