Provider Demographics
NPI:1659374254
Name:ALDERTON, BILLY JO (ARNP)
Entity Type:Individual
Prefix:
First Name:BILLY
Middle Name:JO
Last Name:ALDERTON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1603 MORGAN ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:KEOKUK
Mailing Address - State:IA
Mailing Address - Zip Code:52632-3430
Mailing Address - Country:US
Mailing Address - Phone:319-524-4300
Mailing Address - Fax:319-524-5396
Practice Address - Street 1:1603 MORGAN ST
Practice Address - Street 2:SUITE 3
Practice Address - City:KEOKUK
Practice Address - State:IA
Practice Address - Zip Code:52632-3430
Practice Address - Country:US
Practice Address - Phone:319-524-4300
Practice Address - Fax:319-524-5396
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-27
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAF097652363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
P75284Medicare UPIN