Healthcare Provider Details

I. General information

NPI: 1932761053
Provider Name (Legal Business Name): ALEXA LIANE ARMSTRONG DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2019
Last Update Date: 10/27/2023
Certification Date: 06/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 BARCLAY AVE NE STE 304
GRAND RAPIDS MI
49503-2527
US

IV. Provider business mailing address

330 BARCLAY AVE NE STE 304
GRAND RAPIDS MI
49503-2527
US

V. Phone/Fax

Practice location:
  • Phone: 616-391-2160
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number5151014040
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: