Provider Demographics
NPI:1689059909
Name:ALICIA M. PRICE, AOCNP
Entity type:Organization
Organization Name:ALICIA M. PRICE, AOCNP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:AOCNP
Authorized Official - Phone:704-378-9673
Mailing Address - Street 1:PO BOX 6602
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60121-6602
Mailing Address - Country:US
Mailing Address - Phone:707-378-9673
Mailing Address - Fax:
Practice Address - Street 1:3664 SKYGLADE DR
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60124-5722
Practice Address - Country:US
Practice Address - Phone:646-918-0085
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-28
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty