Basic Information
| Provider Information | |||||||||
| NPI: | 1780941450 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HILLS | ||||||||
| FirstName: | ALEXIS | ||||||||
| MiddleName: | JEAN | ||||||||
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| Credential: | PDHA II | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3245 HOSPITAL DR | ||||||||
| Address2: | |||||||||
| City: | JUNEAU | ||||||||
| State: | AK | ||||||||
| PostalCode: | 998017809 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9074634049 | ||||||||
| FaxNumber: | 9074634032 | ||||||||
| Practice Location | |||||||||
| Address1: | 3245 HOSPITAL DR | ||||||||
| Address2: | |||||||||
| City: | JUNEAU | ||||||||
| State: | AK | ||||||||
| PostalCode: | 998017809 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9074634049 | ||||||||
| FaxNumber: | 9074634032 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/18/2012 | ||||||||
| LastUpdateDate: | 07/16/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 172V00000X | Y | Other Service Providers | Community Health Worker |
ID Information
| ID | Type | State | Issuer | Description | 07-044-PDHAII | 01 | AK | COMMUNITY HEALTH AIDE PROGRAM CERTIFICATION BOARD - FEDERAL CERTIFICATION | OTHER |