Healthcare Provider Details

I. General information

NPI: 1942128244
Provider Name (Legal Business Name): ALISHA RAE BENTLEY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

6204 FLANNIGAN RD
ORLEANS MI
48865-9641
US

IV. Provider business mailing address

6204 FLANNIGAN RD
ORLEANS MI
48865-9641
US

V. Phone/Fax

Practice location:
  • Phone: 231-250-5825
  • Fax:
Mailing address:
  • Phone: 231-250-5825
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number4704354719
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: