Provider Demographics
NPI:1003634742
Name:ALSUP, HILLARY JOY (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:HILLARY
Middle Name:JOY
Last Name:ALSUP
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 CANONBURY CV
Mailing Address - Street 2:
Mailing Address - City:EADS
Mailing Address - State:TN
Mailing Address - Zip Code:38028-3581
Mailing Address - Country:US
Mailing Address - Phone:682-300-0863
Mailing Address - Fax:
Practice Address - Street 1:6005 PARK AVE STE 429B
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-5211
Practice Address - Country:US
Practice Address - Phone:901-546-2223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-01
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2024073185363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily