Healthcare Provider Details

I. General information

NPI: 1083534259
Provider Name (Legal Business Name): ALAINA NICOLE MCKINNON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3757 PLAINFIELD AVE NE
GRAND RAPIDS MI
49525-2403
US

IV. Provider business mailing address

18840 7 MILE RD
REED CITY MI
49677-8339
US

V. Phone/Fax

Practice location:
  • Phone: 616-365-1410
  • Fax: 616-365-1465
Mailing address:
  • Phone: 231-912-0448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302419032
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: