Provider Demographics
NPI:1659670966
Name:HIGHTOWER, ALISHA RENEE (APRN)
Entity Type:Individual
Prefix:
First Name:ALISHA
Middle Name:RENEE
Last Name:HIGHTOWER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ALISHA
Other - Middle Name:RENEE
Other - Last Name:FAULKNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
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 1:912 PARK AVE
Practice Address - Street 2:
Practice Address - City:IRONTON
Practice Address - State:OH
Practice Address - Zip Code:45638-1596
Practice Address - Country:US
Practice Address - Phone:740-532-1100
Practice Address - Fax:740-534-0029
Is Sole Proprietor?:No
Enumeration Date:2011-03-25
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3006879363LF0000X
OHAPRN.CNP.12138363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3129751Medicaid
KY7100157010Medicaid
KYP00939474OtherRR MEDICARE
WV3810020134Medicaid
OHP00939475OtherRR MEDICARE
OHNP41371Medicare PIN
KYP400042859Medicare PIN
OH3129751Medicaid