ALICIA HAGENAU KETCHUM (NPI# 1588080501) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588080501 |
| Entity Type | Individual |
| Full Name | ALICIA HAGENAU KETCHUM |
| Credential | ARNP-C |
| Practice Address |
120 Medical Blvd Ste 102 Spring Hill FL 34609-0220 |
| Mailing Address |
14690 Spring Hill Dr Ste 100 Attn:credentialing Spring Hill FL 34609-8102 |
| Practice Telephone | 3526860086 |
| Practice Fax Number | 3526842081 |
| Mailing Telephone | 3527990046 |
| Mailing Fax Number | 3526062857 |
| Enumeration Date | 2014-03-14 |
| Last Update Date | 2017-02-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
ARNP9278289 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 016886300 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750638433 | Alicia Ketchum | Home Health | 3 New Haven Rd, Painted Post, NY 14870-9326 | 2012-08-13 |
| Street Address |
120 MEDICAL BLVD STE 102 |
| City | SPRING HILL |
| State | FL |
| Zip Code | 34609-0220 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952303125 | Brian C Kroll | Family Medicine | 120 Medical Blvd, Suite 102, Spring Hill, FL 34609-0220 | 2005-06-01 |
| 1518240456 | Leslie A Wagenberg-grella | Surgery | 120 Medical Blvd, Suite 106, Spring Hill, FL 34609-0220 | 2011-09-27 |
| 1194053264 | Spring Hill Hma Medical Group, LLC | Internal Medicine | 120 Medical Blvd, Suite 106, Spring Hill, FL 34609-0220 | 2009-11-30 |
| 1689817918 | Emmed, P.a. | Family Medicine | 120 Medical Blvd, Ste #106, Spring Hill, FL 34609-0220 | 2009-04-16 |
| 1326299306 | North Tampa Orthopaedics Sports Medicine Pa | Orthopaedic Surgery | 120 Medical Blvd, Suite 109, Spring Hill, FL 34609-0220 | 2008-10-08 |
| 1265644876 | Pinnacle Family Medicine Pa | Family Medicine | 120 Medical Blvd, Suite 108, Spring Hill, FL 34609-0220 | 2007-05-04 |
| 1598898140 | Edgar E Lambert Jr. | Massage Therapist | 120 Medical Blvd, Suite 102, Spring Hill, FL 34609-0220 | 2007-03-13 |
| 1851446025 | Joseph C Militello Md Pa | Ophthalmology | 120 Medical Blvd, Suite 101, Spring Hill, FL 34609-0220 | 2007-01-25 |
| 1679503627 | First Choice Family Medical Center, Pa | Family Medicine | 120 Medical Blvd, Suite 102, Spring Hill, FL 34609-0220 | 2006-07-04 |
| 1861446098 | Apple Ophthalmic Pa | Ophthalmology | 120 Medical Blvd, Suite 100, Spring Hill, FL 34609-0220 | 2006-05-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033741970 | Tiffany Dawn Westbrook | Nurse Practitioner | 225 Mariner, Spring Hill, FL 34609 | 2020-02-09 |
| 1215450515 | Jessica Deprimo | Occupational Therapy Assistant | 224-236 Mariner Blvd, Spring Hill, FL 34609 | 2017-07-19 |
| 1760911259 | Sunset Family Inc. | Home Health | 4058 Puffer Trce, Spring Hill, FL 34609 | 2017-06-08 |
| 1073943213 | Isidora Alf, Inc | Assisted Living Facility | 3467 Everett Ave, Spring Hill, FL 34609 | 2013-11-26 |
| 1144667494 | Desiree Gagne | Occupational Therapist | 11216 Spring Hill Dr, Spring Hill, FL 34609 | 2013-05-28 |
| 1659635274 | Miyosia Plummer | Counselor | 7074 Grove Road, Brooksville, FL 34609 | 2012-06-28 |
| 1790074623 | Colleen Landry | Occupational Therapy Assistant | 14075 Cooper Rd, Spring Hill, FL 34609 | 2011-03-31 |
| 1639489438 | Anoop Karanth | Pharmacist | 13303 Haverhill Drive, Springhill, FL 34609 | 2010-10-14 |
| 1619283587 | Spring Hill Primary Care LLC | Internal Medicine | 34 Seven Hills Dr, Spring Hill, FL 34609 | 2010-08-30 |
| 1831330547 | Theresa M. Meloche, A.r.n.p. & Associates, Pllc | Nurse Practitioner | 4120 Charmwood Ave., Spring Hill, FL 34609 | 2009-03-10 |
| Find all providers in zip 34609 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609473958 | Tamara L Walker | Nurse Practitioner | 12084 Rockford St, Spring Hill, FL 34608-2153 | 2020-10-08 |
| 1942858840 | Marci Montague | Nurse Practitioner | 4304 Canongate Ct, Spring Hill, FL 34609-0498 | 2019-09-04 |
| 1861052953 | Kristin N Esenwein | Nurse Practitioner | 11298 Orangewood Ct, Spring Hill, FL 34609-9138 | 2019-06-19 |
| 1821584327 | Barbara Jean Giles | Nurse Practitioner | 11357 Silverwood Ct, Spring Hill, FL 34609-9154 | 2018-07-08 |
| 1043718521 | Jillian Audreya Fawn Stuper | Nurse Practitioner | 21705 Bowman Rd, Spring Hill, FL 34610 | 2018-01-30 |
| 1023568748 | Michelle Annette Perez | Nurse Practitioner | 6475 Sugar Tree Dr, Spring Hill, FL 34607-2517 | 2016-10-05 |
| 1700339181 | Enera Kupi | Nurse Practitioner | 11901 Linden Dr, Spring Hill, FL 34608-4946 | 2016-08-02 |
| 1629421623 | Justin Timothy Reed | Nurse Practitioner | 3001 Reserve Blvd Ste 200, Spring Hill, TN 37174-3101 | 2016-07-14 |
| 1578917225 | Masako Tidrow | Nurse Practitioner | 109 Dakota Dr, Spring Hill, TN 37174-6195 | 2016-04-19 |
| 1467806638 | Brenda Sanchez | Nurse Practitioner | 3098 Campbell Station Pkwy # A-201, Spring Hill, TN 37174-6270 | 2016-04-14 |
| Find all providers in SPRING HILL | ||||
| City | SPRING HILL |
| Zip Code | 34609 |
Please comment or provide details below to improve the information on ALICIA HAGENAU KETCHUM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.