Healthcare Provider Details

I. General information

NPI: 1427471291
Provider Name (Legal Business Name): ALISHIA HARRIS-DIOUF ANP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2014
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27901 WOODWARD AVE STE 300
BERKLEY MI
48072-0921
US

IV. Provider business mailing address

1280 WINDMILL CT
ROCHESTER HILLS MI
48306-4260
US

V. Phone/Fax

Practice location:
  • Phone: 947-523-4500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704244842
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: