Healthcare Provider Details

I. General information

NPI: 1316758816
Provider Name (Legal Business Name): ALANA MARIE KAKISH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2025
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 COLLINS RD
LANSING MI
48910-8394
US

IV. Provider business mailing address

46422 PINEHURST CIR
NORTHVILLE MI
48168-9648
US

V. Phone/Fax

Practice location:
  • Phone: 419-383-4000
  • Fax:
Mailing address:
  • Phone: 248-704-9375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: