Basic Information
Provider Information
NPI: 1295368140
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WHITEHILL
FirstName: ALEX
MiddleName: M
NamePrefix:  
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9100 W 74TH ST
Address2:  
City: OVERLAND PARK
State: KS
PostalCode: 662044004
CountryCode: US
TelephoneNumber: 9146424900
FaxNumber:  
Practice Location
Address1: 9100 W 74TH ST
Address2:  
City: SHAWNEE MISSION
State: KS
PostalCode: 662044004
CountryCode: US
TelephoneNumber: 9136322230
FaxNumber: 9136322297
Other Information
ProviderEnumerationDate: 02/19/2020
LastUpdateDate: 08/03/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/03/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X121808KSN Nursing Service ProvidersRegistered Nurse 
367500000X557776KSY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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