MEDICARE: ALEXANDRA D WHITER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP2300X	Primary Care Nurse Practitioner	4704313669	MI
2	363L00000X	Nurse Practitioner	4704313669	MI

General Provider Information

NPI Number	:	1184381063
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRA D WHITER

Provider Business Mailing Address
First Line	:	3941 HARVARD RD
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48224-2341
Country	:	US
Telephone Number	:	586-909-3793
Fax Number	:

Provider Business Practice Location Address
First Line	:	303 E KEARSLEY ST, FLINT, MI 48502
Second Line	:
City	:	FLINT
State	:	MI
Zip	:	48502
Country	:	US
Telephone Number	:	810-762-3300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/26/2021
Last Update Date	:	06/03/2026

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Directions to “ ALEXANDRA D WHITER ” Practice Location

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