Healthcare Provider Details

I. General information

NPI: 1083552897
Provider Name (Legal Business Name): ALEXIS SHOWALTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 N UNIVERSITY AVE
ANN ARBOR MI
48109-1078
US

IV. Provider business mailing address

123 HUNT ST
TOWANDA IL
61776-7568
US

V. Phone/Fax

Practice location:
  • Phone: 734-763-6933
  • Fax:
Mailing address:
  • Phone: 309-310-8735
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: