Provider Demographics
NPI:1548092000
Name:CARRIGER, ALEXIS R (MPH, RD)
Entity type:Individual
Prefix:MRS
First Name:ALEXIS
Middle Name:R
Last Name:CARRIGER
Suffix:
Gender:F
Credentials:MPH, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7450 CLEMENT RD
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48346-1900
Mailing Address - Country:US
Mailing Address - Phone:248-202-2797
Mailing Address - Fax:
Practice Address - Street 1:7450 CLEMENT RD
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48346-1900
Practice Address - Country:US
Practice Address - Phone:248-202-2797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered