Healthcare Provider Details

I. General information

NPI: 1144817511
Provider Name (Legal Business Name): ALLISON ELIZABETH ALEXANDER LPN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ALLISON ELIZABETH FERRELL

II. Dates (important events)

Enumeration Date: 12/30/2020
Last Update Date: 03/03/2023
Certification Date: 03/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26711 WOODWARD AVE STE LLA
HUNTINGTON WOODS MI
48070-1364
US

IV. Provider business mailing address

26711 WOODWARD AVE STE LLA
HUNTINGTON WOODS MI
48070-1364
US

V. Phone/Fax

Practice location:
  • Phone: 248-688-0334
  • Fax:
Mailing address:
  • Phone: 248-688-0334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License NumberL-150968
License Number State
# 2
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number4703102644
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: