Provider Demographics
NPI:1144817511
Name:ALEXANDER, ALLISON ELIZABETH (LPN, IBCLC)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:ELIZABETH
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:LPN, IBCLC
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:ELIZABETH
Other - Last Name:FERRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:26711 WOODWARD AVE STE LLA
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48070-1364
Mailing Address - Country:US
Mailing Address - Phone:248-688-0334
Mailing Address - Fax:
Practice Address - Street 1:26711 WOODWARD AVE STE LLA
Practice Address - Street 2:
Practice Address - City:HUNTINGTON WOODS
Practice Address - State:MI
Practice Address - Zip Code:48070-1364
Practice Address - Country:US
Practice Address - Phone:248-688-0334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-30
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
L-150968174N00000X
MI4703102644164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No164W00000XNursing Service ProvidersLicensed Practical Nurse