1144817511 NPI number — ALLISON ELIZABETH ALEXANDER LPN, IBCLC

Table of content: ALLISON ELIZABETH ALEXANDER LPN, IBCLC (NPI 1144817511)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144817511 NPI number — ALLISON ELIZABETH ALEXANDER LPN, IBCLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALEXANDER
Provider First Name:
ALLISON
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LPN, IBCLC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FERRELL
Provider Other First Name:
ALLISON
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1144817511
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/03/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
26711 WOODWARD AVE STE LLA
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HUNTINGTON WOODS
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48070-1364
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-688-0334
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
26711 WOODWARD AVE STE LLA
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUNTINGTON WOODS
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48070-1364
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-688-0334
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/30/2020

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174N00000X , with the licence number:  L-150968 ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 164W00000X , with the licence number: 4703102644 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)