Individual
ALICIA R CROSS-TIPTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
120 NE SAINT LUKES BLVD, STE. 200, LEES SUMMIT, MO 64086-6000
(816) 246-4302
(816) 246-9493
Mailing address
5701 W 119TH ST STE 410, OVERLAND PARK, KS 66209-3721
(913) 345-6901
(913) 469-4095
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15-01853
KS
363A00000X
Physician Assistant
2015005495
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4857968
AETNA
—
01
—
P01516242
RR MEDICARE
—
Enumeration date
02/23/2015
Last updated
01/04/2022
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